Perceived community violence is associated with condom use in a high-risk sample of African-American adults

Background: While research suggests that community violence shapes sexual risk behavior among African-American adolescents, no research has explored this relationship among adults. Here we investigate the relationship between perceived community violence and consistent condom use with a primary partner in a high-risk sample of African-American adults.

Methods: The sample consisted of adult African-American residents of five Atlanta public housing communities (N=92). All participants were sexually active in the past year; substance abusers were oversampled. Community violence was defined as a fight in the neighborhood that involved a weapon during the 6-month reporting period. The outcome assessed consistent (100%) condom use with a primary partner during that period. We used generalized estimating equations to analyze the relationship of community violence to this outcome. Two mediators of this relationship (drug dependence and depression) were explored.

Results: Only 12% of participants reported that they had not witnessed community violence during the reporting period. Multivariate results indicate that, compared to individuals reporting no community violence, the odds of consistent condom use with a primary partner were 93% lower among adults who reported community violence at least monthly (p=0.007), and 78% lower among adults who reported community violence less than monthly (p=0.02). Drug dependence and depression mediated this relationship among men.

Conclusions: Perceived community violence was associated with reduced adult condom use. If future studies substantiate these findings, safer sex interventions should address perceived community violence, and other structural interventions should seek to improve access to drug treatment and mental health services in violent communities.