National Survey on HIV Risk for African-American Women

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DESCRIPTION (provided by applicant): Among women, African-American women comprised 63% of AIDS cases and 69.2% of HIV infections from July 1999 through June 2000. Thus, the proposed national, longitudinal study (N= 1000) is designed to examine gendered factors associated with HIV risk in African-American women over a 24-month follow-up period. The proposal is a collaborative effort between Emory University and ORC Macro, a professional survey research firm. We propose using a three-stage proportionate stratified random digit dial methodology to recruit the sample. Stage one involves identifying three strata: city, suburban, and rural regions in the 48 continental United States. Stage two involves identifying eligible households in these strata. Stage three involves identifying eligible individuals in each household. Eligible respondents must be African American women, 18 to 44 years of age, who are unmarried, sexually active within 90 days of the screening, and provide consent. After women return their written informed consent, an interviewer from ORC Macro will administer the Computer-Assisted Telephone Interview. The interview is guided by the theory of Gender and Power. which has been extended and adapted by Drs. Wingood and DiClemente to examine factors associated with HIV risk in women. This theory has three structures, the sexual division of labor (examines socioeconomic influences), the sexual division of power (examines partner and institutional influences) and the structure of cathexis (examines norms and affective influences) that may influence women's HIV risk. Structural equation modeling will be used to examine the following study aims: To determine if the Sexual Division of Labor, specifically, educational attainment, employment status, health insurance status, number of dependents, living arrangements, economic hardship, neighborhood residence, social cohesion, economic dependence on the partner and income predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine if the Sexual Division of Power, specifically, sexual abuse, physical abuse, traumatic life events, sexual harassment, exposure to sexually degrading media, racial discrimination, partner communication, partner resistance to condom use, male partner's and women's use of alcohol and drugs predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine if the Structure of Cathexis, specifically, pregnancy desire, gender norms, spirituality, partner availability, partner age, relationship status, relationship length, relationship commitment, relationship satisfaction, HIV stigma and sexual dysfunction, predict unprotected sexual intercourse and multiple partners over the two-year follow-up period. To determine the unique variance that each of the three latent constructs (Sexual Division of Labor, Sexual Division of Power and Structure of Cathexis) explains in the model over the two-year follow-up period.