Chronic Heavy Alcohol use and High Risk Behavior among Black Women in Los Angeles County

Background:Although the annual estimated rate of HIV diagnosis for black women has decreased significantly it is still approximately 15 times the rate for white women. Poverty, low perception of risk, relationship inequality and drug and alcohol use have been identified as factors contributing to this disparity. This study investigated the association between chronic heavy alcohol (CHA) use and HIV risk behaviors in a 2007 sample of urban black women.

Methods: Black women (n=425) were recruited from high HIV morbidity and high poverty areas in Los Angeles County to complete HIV testing and a survey on HIV risk behaviors. ANOVA and logistic regression were used to investigate the association between CHA use, HIV risk behaviors and exposure to HIV prevention.

Results: Participants' mean age was 33 years and 85% earned less than $20,000 annually. HIV prevalence was 0.5% and 15% reported a history of STDs. Few CHA users (6%) and non-users (5%) reported recent exposure to HIV prevention counseling. After controlling for potential confounders, CHA users had 2.2 times greater odds of multiple male sex partners and 2.3 times greater odds of unprotected sex with casual or exchange partners in the previous 12 months.

Conclusions: Within this socially disadvantaged population, characterized by high HIV risk behavior and low exposure to HIV prevention, chronic heavy alcohol use was associated with higher HIV-related risk behaviors. These findings support the notion of the disinhibiting role of alcohol with respect to HIV risk behaviors. Future HIV prevention for women should include alcohol treatment programs.