Relationship of psychosocial factors to HIV risk among Haitian women.

This study describes the prevalence of HIV risk behaviors among low-income, Haitian women, identifies theoretically relevant mediating psychosocial HIV risk predictors, and provides formative data for developing culturally and gender sensitive interventions for this distinctive, high risk, and understudied population. Confidential interview surveys were administered to 101 women of Haitian descent while they awaited their medical appointments at a local low-income, community medical clinic. Moderately high levels of sexual risk behavior (i.e., unprotected sex with nonmonogamous partners; multiple lifetime partners) were reported. On average, these women reported a belief in their HIV susceptibility, relatively little HIV-related anxiety, somewhat inadequate levels of communication regarding safer sex practices, and lack of adequate confidence in their ability to negotiate safer behaviors in sexual encounters. Both personal and partner condom attitudes were unfavorable and these attitudes predicted condom use levels. It was concluded that interventions need to be developed for Haitian women to improve their attitudes toward condom use and their confidence in negotiating safer sexual practices. However, these interventions cannot be developed in a vacuum. Although it is crucial to consider the woman's individual attitudes and behaviors, it is also important to consider the male partner's attitudes toward sex and the woman's relationship with her male partner within the context of Haitian culture. Only by determining and targeting important potential motivations for safe sex within the cultural context can we most effectively reduce HIV sex risk behavior in Haitian women.

Correlates of first intercourse among women in Jamaica.

This study examines retrospective reports of factors anticipated to impact first intercourse in a random sample of 897 Jamaican women, and contributes to our understanding of the relationship between sexual risk, knowledge, and economic and demographic correlates of first intercourse. A relationship between initiation of intercourse prior to the age of consent (16 years) and factors occurring at or around the time of first intercourse was found. Early initiators were more likely to have had less early family stability and to have experienced menarche at a younger age than late initiators. Although early initiators of intercourse were more likely to report lower socioeconomic status, less STD knowledge, and greater numbers of pregnancies, they were no more likely to report more sexual partners than women who engaged in first intercourse after the age of consent, and had a greater number of long-term relationships. Regardless of age of first intercourse, women need to be made aware of the risks of sexual contact so that they can make informed decisions about the consequences of sexual activity. Overall, results are consistent with work conducted in other parts of the Caribbean and America regarding the age at which young women engage in first intercourse. Findings suggest the need for further work exploring expectations at first intercourse such as marriage, economic support, or relationship stability. Implications of these findings are discussed within the context of economic and structural factors that both increase and decrease risks.

PIP: This study examines retrospective reports of factors anticipated to impact first intercourse among 897 women selected randomly in Jamaica. Three groups of factors were associated with early vs. late initiation of intercourse. A significant association was noted between family structure in childhood and age of first intercourse. Women growing up in one-parent families were more likely to engage in intercourse before the age of 16. The age of menarche was also significantly associated with age of intercourse. The characteristics of the first sexual partner and the characteristics of the relationship were significantly associated with the age of intercourse. On the other hand, there are four sets of variables assessing current demographic characteristics, current relationship status, and factors such as religiosity and knowledge on sexually transmitted diseases (STDs). It was observed that early initiators of intercourse were more likely to report lower socioeconomic status, less STD knowledge, and a greater number of pregnancies. This study identifies some of the circumstances of first intercourse, which highlight the need to develop health and educational intervention programs that offer more options to young adolescents who may consider early childbearing to stabilize relationships.

Exploring AIDS-related knowledge, attitudes, and behaviors of female Mexican migrant workers.

AIDS-related knowledge, attitudes, and behaviors were assessed in female Mexican migrant laborers. Thirty-two women were administered a modified version of the Hispanic Condom Questionnaire. Respondents were knowledgeable about the major modes of HIV transmission, but one-third to one-half of the women believed that they could contract AIDS from unlikely casual sources. Although respondents reported few negative beliefs about condom use, actual condom use with sex partners was low and knowledge of proper condom use was problematic. Consequently, 75 percent reported never carrying condoms. Implications of these findings for future research and provision of services for female Mexican migrants are discussed.

PIP: According to US Department of Health and Human Services data for 1990, there are approximately 4.1 million migrant workers in the US, mainly of Mexican background. Half of all Mexican immigrants over the past 2 decades have been women. Findings are presented from a December 1992 assessment of AIDS-related knowledge, attitudes, and behaviors among a sample of female Mexican migrant laborers in Jalisco, Mexico, a small agricultural sending community 210 km from Guadalajara. The 32 women administered a modified version of the Hispanic Condom Questionnaire were of mean age 34.2 years and had lived and worked in the US since 1982. Women currently living in the US were visiting Jalisco for the Christmas holiday. Although the surveyed women were knowledgeable about the major modes of HIV transmission, 33-50% believed that they could contract AIDS from unlikely casual sources. Respondents reported few negative beliefs about condom use, but actual condom use with sex partners was low and knowledge of proper condom use was inadequate. 42% reported ever using a condom and 75% reported almost never carrying condoms. The implications of these findings are discussed with regard to future research and the provision of services to female Mexican migrants.

Sexual abuse during childhood and adolescence as predictors of HIV-related sexual risk during adulthood among female sexual partners of injection drug users.

PIP: This study explores the relationship of sexual abuse during childhood and adolescence with HIV-related sexual risk behaviors during adulthood among female sexual partners of injection drug users. It analyzed data that was gathered between 1990 and 1993, which included a sample of 2794 women from the US, Mexico, and Puerto Rico. 6 HIV-related sexual risk behaviors that occurred during the month prior to interview were examined; namely, number of sexual partners, number of drug-injecting sexual partners, number of sexual intercourse while high on alcohol and/or other drugs, number of times trading sex for drugs and/or money, proportion of all sexual acts involving protection, and overall HIV-related sexual risk. The results showed that more than one-third of the women (36.3%) experienced some form of sexual abuse during childhood, whereas 34.4% reported that they had been abused sexually during adolescence; 1 in 5 women (18.4%) stated being abused during both periods. The results further indicate that there is a strong link between sexual abuse victimization early in life and involvement later in life in HIV-related sexual risk behaviors. It was found out that certain forms of sexual abuse, such as forced exposure and touching of one's sexual parts were more strongly related than other forms of sexual abuse to subsequent involvement in HIV-related sexual behaviors.^ieng

Condom use among high-risk women in Honduras: evaluation of an AIDS prevention program.

In 1988, the Honduran Ministry of Health initiated an intervention study designed to increase AIDS awareness and promote preventive behavior, especially condom use, among registered commercial sex workers (CSWs). The program consisted of weekly talks and free condom distribution to all CSWs who attended the sexually transmitted disease clinic during a 10-week period. Pre- and postintervention surveys were used to evaluate change in knowledge and condom use. Condom diaries were used to measure condom use during the program. One hundred thirty-four women who participated in the intervention completed the initial and follow-up surveys. There was a statistically significant increase in mean condom use from 64% to 70% of client contacts. Condom use recorded in diaries during the program period appeared even higher. Factors found to be associated with increased use postintervention include low baseline condom use and higher client fee. The reliability of the methods of measuring condom use and the implications of the findings for future intervention studies among sex workers and their clients are discussed.