267793 Influence of age on sexual risk behaviors and condom use attitudes among heterosexual women with histories of methamphetamine use and partner violence

Sunday, October 28, 2012

Natasha Ludwig-Barron, MPH , Division of Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA
Jamila K. Stockman, PhD, MPH , Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA
Karla D. Wagner, PhD , Division of Global Public Health, University of California San Diego, San Diego, CA
Jennifer Syvertsen, PhD, MPH , University of South Florida, Tampa, FL
Shirley J. Semple, PhD , Department of Psychiatry, University of California, San Diego, La Jolla, CA
Thomas Patterson, PhD , Dept of Psychiatry, University of California, La Jolla, CA
Background: Intersecting epidemics of HIV and partner violence (PV) disproportionately affect drug-using women, yet few studies have identified the health risks associated with age. Purpose: This study compared sexual risk behaviors, condom use attitudes and HIV knowledge between midlife/older women (ages 45+) and younger women (ages 18-44), reporting methamphetamine (MA) use and PV. Methods: A sequential mixed methods design used themes from qualitative in-depth interviews (n=19) to inform logistic regression analysis of data from HIV-negative, heterosexual, MA-using women enrolled in an HIV behavioral intervention trial in San Diego, CA, who reported lifetime physical or sexual PV (n=154). Results: Qualitative themes included: age appropriateness of prevention methods, physiological barriers, condom use attitudes and former high-risk behaviors. Of the 154 women, 21.4% were aged ≥ 45, 80.5% were unemployed and 51.3% had a felony conviction. Midlife/older age was associated with fewer episodes of unprotected vaginal sex with a steady partner, greater number of sex partners within the last 60 days, lower condom use self-efficacy, lower positive outcome expectancies for condom use and lower HIV knowledge scores. In multivariate logistic regression, age remained independently associated with unprotected vaginal sex with a steady partner (AdjOR: 0.94; 95% CI: 0.91-0.98), number of sex partners (AdjOR: 1.054; 95% CI: 1.00-1.119), condom use self-efficacy (AdjOR: 0.27; 95% CI: 0.13-0.59) and HIV knowledge (AdjOR: 0.03; 95% CI: <0.001-1.13). Conclusion: Midlife/older drug-using women with histories of PV may have different HIV sexual risk profiles than their younger counterparts that should be addressed when developing future interventions.

Learning Areas:
Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences

Learning Objectives:
Following this presentation, attendees will be able to: (1) Describe specific health implications that disproportionately affect drug-using women. (2) Compare the sexual health risks of older (age 45+) drug-using women with histories of partner violence, with their younger counterparts, and provide suggestions on how to address these issues.

Keywords: Battered Women, Women and HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the study coordinator for multiple federally funded grants with the University of California, San Diego, and have submitted a mixed methods study which includes a secondary data analysis with qualitative results from in-depth interviews. I am under the direction of Jamila Stockman, PhD, Dr. Thomas Patterson, PhD and Shirley Semple, PhD who are my mentors and co-investigators on the submitted work.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.