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

描述(申请人提供)：人类免疫缺陷病毒(HIV)的异性传播以流行的比例影响老年非裔美国人(AA)妇女；艾滋病目前是50岁及以上AA妇女的第五大死因。然而，针对这一弱势群体的研究和降低风险干预措施很少。生活在贫困中的老年城市AA妇女感染艾滋病毒的风险高得不成比例。虽然一些关于艾滋病毒相关性行为风险的研究已经包括了少数老年再障妇女，但这些研究的结果并没有涉及可能影响避孕套使用意向的社会规范角色和性别权力相关因素。老年AA妇女有效协商使用避孕套的能力可能受性危险行为和保护策略的影响，包括对避孕套的看法、态度和信念，以及她们在性关系中的权力信念。大多数艾滋病毒研究和公共卫生干预措施都是针对白人女性和年轻的AA女性。因此，我们对老年再生障碍性贫血妇女中HIV性风险的影响的了解是有限的。这项拟议的前瞻性定量研究旨在检查影响城市AA老年妇女与艾滋病毒相关的性风险和防护行为的因素，包括使用避孕套。本研究的目的是：(1)前瞻性考察城市AA老年妇女3个月随访中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避孕套使用意向的影响；(2)前瞻性考察城市AA老年妇女3个月随访中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避孕套使用频率的影响。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女性作为样本，要求她们在基线和3个月的随访时完成问卷调查。这些网站为来自不同文化背景和医疗服务不足的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、SES、避孕套使用和性风险相关的信念和态度、关系和关系权力，以及他们使用避孕套的意图和实际使用情况。将使用多元Logistic回归和/或相对风险技术来分析数据。这项研究的结果将为为城市AA老年妇女制定基于理论、特定年龄和文化的艾滋病毒风险降低干预措施提供信息。 公共卫生相关性：老年非裔美国妇女感染艾滋病毒的风险高得不成比例。然而，我们对老年非裔美国妇女中艾滋病毒性行为风险的影响的了解非常有限，因为大多数艾滋病毒预防研究和干预措施都是针对年轻妇女的。这项拟议的定量研究试图通过前瞻性地检查个人因素(信仰和态度)和社会文化因素(性别/关系权力)对老年城市非裔美国女性避孕套使用意图和行为的影响，来解决这一文献中的差距。

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. PUBLIC HEALTH RELEVANCE: Older African American women face a disproportionately high risk for becoming infected with HIV. However, our understanding of the influences of HIV sexual risk among older African American women is very limited as most HIV prevention research and interventions have targeted younger women. The proposed quantitative study seeks to address this gap in the literature by prospectively examining the influence of individual factors (beliefs and attitudes) and socio-cultural factors (gender/relationship power) on older urban African American women's condom use intentions and behaviors.