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

描述（由申请人提供）：异性传播的人类免疫缺陷病毒（HIV）影响着老年非洲裔美国妇女（AA）的流行病比例；艾滋病现在是50岁及以上AA妇女死亡的第五大原因。然而，针对这一弱势群体的研究和减少风险的干预措施缺乏。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。尽管一些与HIV相关的性风险的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避孕套使用意图的社会规范角色和性别权力相关因素。年长的AA女性有效协商使用避孕套的能力可能受到她们的性风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的目标是白人妇女和年轻的AA妇女。因此，我们对老年AA妇女中HIV性风险影响的理解是有限的。该前瞻性定量研究旨在研究影响老年城市AA妇女艾滋病毒相关性风险和保护性行为的因素，包括避孕套的使用。本研究的目的是：(1)前瞻性考察城市AA老年妇女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)前瞻性地考察了城市AA老年妇女hiv相关行为信念、规范信念、控制信念、关系因素和关系力量对安全套使用频率的影响。从纽约市布鲁克林和皇后区的社区卫生中心招募了228名50岁以上的AA女性，并要求她们在基线和3个月的随访期间完成问卷调查。这些站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、避孕套使用和性风险相关的信仰和态度、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。多元逻辑回归和/或相对风险技术将用于分析数据。这项研究的发现将为基于理论的、针对年龄和文化的老年城市AA妇女的艾滋病毒风险降低干预措施的发展提供信息。

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.