Sexual practices and HIV risk behaviors among African American women partners of sex-trading men who have sex with men and women: A descriptive analysis

Background: African American women continue to be affected disproportionately by HIV/AIDS and other sexually transmitted infections. Prevention efforts focusing on individual behavior have failed to produce a significant reduction in the incidence of HIV in the African American community during the past 20 years. This has directed greater attention to network epidemiology and the structural factors-of racism, community disorganization, poverty, and gender inequality that contribute to the formation of sexual network patterns of African American women. The current study explores the HIV related behaviors of a group of African American women at the high-risk margins of the African American community. These women are the primary partners of male sex workers who have sex with both men and women (MSMW). Methods: African American women primary partners (N=106) completed a self-report questionnaire using Audio Computer-Assisted Self Interviewing (ACASI), regarding drug using behavior, sexual practices, sexual behavior, HIV and STI history. Results: Descriptive and univariate analyses determined the majority of the participants were unemployed, were unstably housed, had a history of incarceration, used crack cocaine, engaged in unprotected sex. A majority of the participants did not know their HIV status, and half reported having an STI within the last 12 months with higher rates of STIs reported for participants who used crack. Conclusions: Prevention programs targeted for this population of African American women must consider the STI and HIV risks that are present on many levels and that behavioral decisions are influenced by structural and contextual factors as well as individual agency.