AIDS and Behavior

, Volume 20, Issue 6, pp 1334–1342 | Cite as

Individual and Partner-Level Factors Associated with Condom Non-Use Among African American STI Clinic Attendees in the Deep South: An Event-Level Analysis

  • Brandon D. L. Marshall
  • Amaya G. Perez-Brumer
  • Sarah MacCarthy
  • Leandro Mena
  • Philip A. Chan
  • Caitlin Towey
  • Nancy Barnett
  • Sharon Parker
  • Arti Barnes
  • Lauren Brinkley-Rubinstein
  • Jennifer S. Rose
  • Amy S. Nunn
Original Paper


The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determinants that result in partner dependency and sexual risk behavior.


HIV Concurrency Substance use Contraceptive use African Americans 


La epidemia de VIH/SIDA en los Estados Unidos se concentra en el sur del país, pero los factores que contribuyen a la transmisión del VIH no se entienden completamente. Examinamos las relaciones entre el consume de drogas y alcohol, las características sexuales entre parejas, y el uso de condón en una muestra de personas afroamericano reclutado de una clínica de ITS en Jackson, Mississippi. Entre enero y junio del 2011, con hasta tres parejas sexuales recientes reportados por los participantes evaluamos el uso de condón durante el último acto sexual. Correlatos del uso de condón, al nivel del participante y de la pareja, fueron examinados usando ecuaciones de estimación generalizadas. Los 1.295 participantes informaron de 2.880 eventos coito, de los cuales 1.490 (51,7 %) reportaron no usar un condón. La mayor edad, menor nivel educativo, informando dependencia financiera o material con una pareja sexual, relaciones sexuales con una pareja principal, y una mayor frecuencia de relaciones sexuales fueron asociados con mayores probabilidades de sexo sin condón. Los esfuerzos de prevención del VIH en el sur de los Estados Unidos deberían abordar las disparidades socioeconómicas subyacentes y determinantes estructurales que resultan de la dependencia de pareja y comportamiento sexual de riesgo.



BDLM is supported in part by the National Institute on Drug Abuse (DP2 DA040236). APB is supported by Eunice Kennedy Shriver National Institute of Child Health & Human Development (T32 HD049339) and the National Institutes of Mental Health (R25 MH083620). SM is supported by T32 DA13911 and P30 AI042853 from the National Institute Of Allergy And Infectious Diseases. SP is supported by T32 DA13911 and R25 MH083620. ASN is supported by the National Institute on Alcohol Abuse and Alcoholism (K01 AA020228). Additional support was received from the MAC AIDS Fund. This research was made possible by the Brown/Lifespan/Tufts Center for AIDS Research and the Brown University Center for Alcohol and Addiction Studies.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Brandon D. L. Marshall
    • 1
  • Amaya G. Perez-Brumer
    • 2
  • Sarah MacCarthy
    • 3
  • Leandro Mena
    • 5
  • Philip A. Chan
    • 4
    • 6
  • Caitlin Towey
    • 7
  • Nancy Barnett
    • 7
  • Sharon Parker
    • 4
    • 8
  • Arti Barnes
    • 9
  • Lauren Brinkley-Rubinstein
    • 4
    • 6
  • Jennifer S. Rose
    • 10
  • Amy S. Nunn
    • 7
    • 11
  1. 1.Department of EpidemiologyBrown University School of Public HealthProvidenceUSA
  2. 2.Department of Sociomedical SciencesColumbia Mailman School of Public HealthNew YorkUSA
  3. 3.Behavioral and Policy SciencesRAND CorporationSanta MonicaUSA
  4. 4.Division of Infectious DiseasesThe Miriam HospitalProvidenceUSA
  5. 5.Division of Infectious DiseasesUniversity of Mississippi Medical CenterJacksonUSA
  6. 6.The Warren Alpert School of MedicineBrown UniversityProvidenceUSA
  7. 7.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  8. 8.Joint Master of Social Work ProgramNorth Carolina A&T State UniversityGreensboroUSA
  9. 9.Department of Internal MedicineUT Southwestern Medical CenterDallasUSA
  10. 10.Department of PsychologyWesleyan UniversityMiddletownUSA
  11. 11.The Rhode Island Public Health InstituteBrown UniversityProvidenceUSA

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