Shades of black: Investigating within-group differences in African-American women's HIV risk behavior

Background: HIV is a leading cause of death for African-American women. However, most of the published research on HIV prevention is based on findings from studies on African-American women in the low-education/low-income group. This study examined how the impact of gender-ratio imbalance in the African-American community influences HIV risk behavior in unmarried, college-educated African-American women ages 25-34, an understudied group. Quantitative data from a nation-wide internet-based survey was used to develop a new scale to measure perceptions of gender-ratio imbalance in this group with regard to HIV prevention.

Method: 262 unmarried, college-educated African-American women age 25-34 completed our internet-based survey. Pearson correlations were used to investigate the relationship between Gender-Ratio Imbalance (GRI) and Sexual Self-efficacy. Hierarchical Logistic Regression was used to identify variables predicting non-condom use in African-American college-educated women.

Results: A low negative relationship was identified between GRI and Sexual Self-efficacy. Not currently being in a relationship, not having children, and being in a work environment that is not predominately African-American predicted greater likelihood of condom use at last sex. Having a current boyfriend or serious relationship predicted greater likelihood of non-condom use at last sex.

Conclusions: This study presents context for decision-making around non-condom use among this group of women. Demographic and HIV risk behavior profiles of participants' male partners were created. Future directions for the development of a psychological scale to measure gender-ratio scale, as well as implications for HIV prevention research investigating within-group differences among African-American women for HIV intervention are presented.