HIV/AIDS risk among midlife African-American women: Does the influence of early socialization on norms, roles and behavior matter?

African American women, who represent only 14% of the female population in the U.S., account for approximately two-thirds of the HIV positive women and over half of those with AIDS. High risk heterosexual exposure is their primary mode of transmission. The risk, however, is not borne just by younger women. Interestingly, even among sexually active, midlife or older African-American women (i.e., 40-65 years old), rates are steadily increasing for those living with HIV and for HIV/AIDS-related mortality. The purpose of this investigation was to explore whether early socialization and the early establishment of norms and roles influence risk-taking sexual behaviors throughout midlife for African-American women. The study's methodology utilized individual interviews and focus groups to elicit their attitudes, beliefs, role expectations and behaviors associated with HIV/AIDS risk. In addition, the investigation was designed to ascertain the dominance and influence of long-held norms and customary sexual practices in spite of the known associated risks for contracting HIV/AIDS and the widespread educational campaigns aimed at reducing the risk of exposure. The results highlight the need to target this population at a time when the U.S. is witnessing unprecedented growth in the number of older adults. Therefore, efforts are warranted to get to the core in understanding the dynamics of sexual risk-taking and decision-making among midlife African-American women. Subsequently, effective risk-prevention strategies can be designed, implemented and evaluated that are relevant, appropriate and acceptable to promote lifesaving actions and to enhance their quality of life across the lifespan.