Gender Power and HIV-Related Sexual Risk Behavior in Older African American Women

描述（由申请人提供）：人类免疫缺陷病毒（HIV）的异性性传播以流行病的比例影响老年非裔美国人（AA）妇女;艾滋病现在是50岁及以上AA妇女的第五大死亡原因。然而，针对这一弱势群体的研究和减少风险的干预措施很少。生活贫困的城市AA老年妇女感染艾滋病毒的风险更高。虽然一些与艾滋病毒有关的性风险研究包括了少数老年AA妇女，但这些研究的结果并没有解决可能影响安全套使用意愿的社会规范角色和性别权力相关因素。老年AA妇女的能力，有效地协商安全套的使用可能会受到他们的性风险行为和保护策略，包括观念，态度和信念，以及他们的权力信念，在他们的性关系。大多数艾滋病毒研究和公共卫生干预措施针对的是白色妇女和年轻的AA妇女。因此，我们对老年AA妇女中艾滋病毒性风险的影响的理解是有限的。拟议的前瞻性定量研究旨在探讨影响城市老年AA妇女的艾滋病毒相关的性风险和保护行为，包括安全套的使用的因素。本研究的目的是：（1）在3个月的随访中，前瞻性地考察城市AA老年妇女的HIV相关行为信念、规范信念、控制信念、关系因素和关系权力对安全套使用意愿的影响;（2）前瞻性地考察HIV相关行为信念、规范信念、控制信念城市老年AA妇女3个月随访时安全套使用频率的关系因素和关系权力。将从纽约市布鲁克林和皇后区的社区卫生中心招募228名50岁以上的AA妇女，并要求她们在基线和3个月随访时完成问卷调查。这些医疗点为来自不同文化和医疗服务不足人群的大量患者提供护理。参与者将被问及他们的人口背景，就业，社会经济地位，安全套的使用和性风险相关的信念和态度，关系和关系权力，以及他们的意图和实际使用安全套。将使用多元逻辑回归和/或相对风险技术分析数据。该研究的结果将为城市AA老年妇女制定基于理论的、针对特定年龄和文化的艾滋病毒风险降低干预措施提供信息。

DESCRIPTION (provided by applicant): Heterosexual transmission of Human immunodeficiency virus (HIV) affects older African American (AA) women in epidemic proportions; AIDS is now the fifth leading cause of death among AA women ages 50 and older. Yet, there is a paucity of research and risk reduction interventions that target this vulnerable population. Older urban AA women living in poverty face a disproportionately higher risk of becoming infected with HIV. Although some studies of HIV- related sexual risk have included older AA women in small numbers, the findings of these studies did not address the social normative roles and gender power related factors that may influence condom use intentions. Older AA women's ability to effectively negotiate condom use maybe influenced by their sexual risk behaviors and protective strategies including perceptions, attitudes, and beliefs about condoms as well as by their power beliefs in their sexual relationships. Most HIV research and public health interventions target white women and younger AA women. Thus, our understanding of the influences of HIV sexual risk among older AA women is limited. The proposed prospective quantitative study seeks to examine factors that influence older urban AA women's HIV-related sexual risk and protective behaviors, including condom use. The aims for the proposed study are to: (1) prospectively examine the influence of HIV-related behavioral beliefs, normative beliefs, control beliefs, relationship factors and relationship power with condom use intentions at 3-month follow-up among older urban AA women; and (2) prospectively examine the influence of HIV-related behavioral beliefs, normative beliefs, control beliefs, relationship factors and relationship power with condom use frequency at 3-month follow-up among older urban AA women. A sample of 228 AA women over age 50 will be recruited from community health centers in the Brooklyn and Queens boroughs of New York City and asked to complete questionnaires at baseline and 3-month follow-up. These sites provide care for a large number of patients from culturally diverse and medically underserved populations. Participants will be questioned regarding their demographic background, employment, SES, condom use and sexual risk-related beliefs and attitudes, relationships and relationship power, and their intentions and actual use of condoms. Multiple logistic regression and/or relative risk techniques will be used to analyze the data. The findings of the study will inform the development of theory-based, age- and culture-specific HIV risk reduction interventions for older urban AA women.