Influence of social support, sense of community, experience of community violence, and trauma history on sexual risk, substance use, and victimization in African American women

Background: Bioecological Systems Theory (BST; Bronfenbrenner, 1993) may help us understand the context of multiple risk issues in low income African American women at disproportionate HIV risk. Preliminary baseline data from an ongoing prospective study were used to examine one of several BST-based models, including individual and sociocultural variables as they relate to sexual risk, substance use, and victimization. Method: Participants were African American women living in public housing developments in Milwaukee, WI (N=245). Baseline ACASI interviews assessed individual [trauma history (physical abuse, sexual coercion)], and sociocultural [social support (SS), experience of community violence, sense of community] variables as they relate to substance use [SU: alcohol and drug problems, days use total], recent victimization, and sexual risk (proportion of unprotected to all vaginal sex occasions). Non-normally distributed data were transformed. We performed structural equation modeling (SEM) with exogenous predictors and latent variables, and fit a reduced form of the model using WLSMV. Fit was confirmed using MPlus' (v.7) adjusted chi-square goodness-of-fit index. Results: When community-level variables and trauma history were introduced, relationships between substance use, victimization and sexual risk became nonsignificant. Significant relationships included (SE): Trauma history on Violence experience [.470 (.052), p<.000], SS [.418 (.140), p=.003], victimization [.474 (.120), p<.000], and SU [.637 (.075); p<.000]; and SS on sense of community [.-.216 (.037), p<.000]. Chi-Square(120) = 542.962, p <.0000; CFI = .891; TLI = .862; RMSEA = .045. Conclusions: These preliminary findings suggest the importance of addressing trauma history and sociocontextual variables in HIV risk reduction intervention content.