AIDS and Behavior

, Volume 22, Issue 6, pp 1944–1954 | Cite as

Assessing the Theory of Gender and Power: HIV Risk Among Heterosexual Minority Dyads

  • Deborah J. Rinehart
  • Alia A. Al-Tayyib
  • Catlainn Sionean
  • Nancy Rumbaugh Whitesell
  • Susan Dreisbach
  • Sheana Bull
Behavioral Surveillance


This study drew on the Theory of Gender and Power (TGP) as a framework to assess power inequalities within heterosexual dyads and their effects on women. Structural equation modeling was used to better understand the relationship between structural and interpersonal power and HIV sexual risk within African American and Latina women’s heterosexual dyads. The main outcome variable was women’s sexual HIV risk in the dyad and was created using women’s reports of condomless sex with their main male partners and partners’ reports of their HIV risk behaviors. Theoretical associations developed a priori yielded a well-fitting model that explained almost a quarter of the variance in women’s sexual HIV risk in main partner dyads. Women’s and partner structural power were indirectly associated with women’s sexual HIV risk through substance use and interpersonal power. Interpersonal power was directly associated with risk. In addition, this study found that not identifying as heterosexual was directly and indirectly associated with women’s heterosexual sex risk. This study provides further support for the utility of the TGP and the relevance of gender-related power dynamics for HIV prevention among heterosexually-active women.


Theory of gender and power HIV risk Sexually transmitted infections (STI) Structural equation modeling (SEM) 



The authors would like to acknowledge the support of the Denver, CO NHBS Partner Study site Principal Investigator Mark Thrun and data analyst Theresa Mickiewicz as well as the following NHBS Partner Study sites and researchers: Dallas, TX: Shane Sheu, Sharon Melville, Richard Yeager, Jim Dyer, Nandita Chaudhuri, Alicia Novoa; Detroit, MI: Renee McCoy, Vivian Griffin, Eve Mokotoff; Houston, TX: Marcia Wolverton, Jan Risser, Hafeez Rehman; Los Angeles, CA: Trista Bingham, Ekow Sey; Miami & Ft. Lauderdale, FL: Marlene LaLota, Lisa Metsch, David Forrest., Dano Beck, Stefanie White; New York City, NY: Alan Neaigus, Chris Murrill, Samuel Jenness, Holly Hagan, and Travis Wendel; San Francisco CA: H Fisher Raymond, Willi McFarland, Hong-Ha Truong; Seattle, WA: Maria Courogen, Hanne Thiede, Nadine Snyder, Richard Burt; St Louis, MO: Michael Herbert, Yelena Friedberg, Dean Klinkenberg, LaBraunna Friend. The authors would also like to acknowledge the support of the Center for Disease Control and Prevention’s Behavioral and Clinical Surveillance Branch, Division of HIV/AIDS Prevention, NHBS team: Teresa Finlayson, Nevin Krishna and Binh Le.


The findings and conclusions of this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.


This study was funded in part of the Centers for Disease Control and Prevention (Grant #U62-PS000954-02). Data collection was based on CDC study protocols as part of the National HIV Behavioral Surveillance System.

Compliance with Ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. The current data analysis was approved under the Colorado Multiple Institutional Review Board (Protocol # 06-0517).

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Center for Health Systems Research, Denver Health and Hospital AuthorityDenverUSA
  2. 2.Department of Medicine, School of MedicineUniversity of ColoradoAuroraUSA
  3. 3.Denver Public Health DepartmentDenver Health and Hospital AuthorityDenverUSA
  4. 4.Department of Epidemiology, School of Public HealthUniversity of ColoradoAuroraUSA
  5. 5.Division of HIV/AIDS PreventionCenters for Disease Control and PreventionAtlantaUSA
  6. 6.Department of Community and Behavioral Health, Colorado School of Public HealthUniversity of ColoradoAuroraUSA
  7. 7.Department of Health and Behavioral Sciences, College of Liberal Arts and SciencesUniversity of Colorado DenverDenverUSA

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