Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #104837

Larry M. Gant, CSW, PhD, School of Social Work, University of Michigan, 1080 S. University, Ann Arbor, MI 48109, 734-763-5990, Lmgant@umich.edu

• Background: Before the current association of African-American HIV infection rates through unprotected sex with behaviorally bisexual men, there were robust associations between rates of HV infection among African-American women and (male) injection drug users.

• Study objectives and research questions: Did one group of men replace another? Are there specific, demonstrable associations between the rates of HIV infection among African-American women and behaviorally bisexual men? If the connections between HIV infection and IDU no longer persist, when did that occur and why? Or, are there still connections between IDU and HIV infection among African-American women?

• Methods: We obtained national and state specific new HIV infection rates among African-American women, estimates of African American men identifying as gay, bisexual or MSM; CDC estimates of bisexual behaviorally acquired HIV, number of infection rates among IDUs, sex ratios, and estimates of African-American IDUs. We conducted spatial regression analysis with dependent variable of HIV infections among African-American women. We also report data from a second project on the associations between HIV risk, relationship power, and measures of women's deference to men in relationships.

• Results: The relationship between MSM and new HIV infections was found to be nonsignificant, with more robust relationships between new infections and sex ratios and IDU rates. Regional variations in African-American female HIV infections were also noted and are discussed. Changes in relationship power (the ability to negotiate decisions of relational and sexual nature) vary directly with willingness to engage in risk behavior as well.

• Conclusions: Discussion of the downlow phenomenon sells books but is not corroborated by empirical research. Sex with IDUs and active drug users remains a strong predictor of HIV infection, moderated by sex ratios and mediated by women's perceptions of relationship dominance. Scapegoating of African-American men who engage (regardless of sex orientation identification or not) in same sex behaviors and sex with women provides a distraction from other, more directly addressable issues of personal behavior and structural realities.

Learning Objectives:

• Understand the current logic underscoring the downlow issues in African-Americans.
• Review the historical connections between HIV infections among women and injection drug users.
• Understand disconnect between downlow presentations and epidemiology.
• Understand recommendations for more effective interventions in the future

Keywords: HIV Risk Behavior, Minority Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation