American Journal of Community Psychology

, Volume 26, Issue 1, pp 7–28 | Cite as

Factors Influencing Condom Use Among African American Women: Implications for Risk Reduction Interventions

  • Janet S. St. Lawrence
  • Gloria D. Eldridge
  • David Reitman
  • Connie E. Little
  • Millicent C. Shelby
  • Ted L. Brasfield


Examined factors associated with condom use in a community-based sample of 423 sexually active African American women. Measures were selected to reflect the components in prevailing models of health behavior. Condom users were higher on AIDS health priority, prevention attitudes, stage of change, behavioral intentions, reported more frequent and comfortable sexual communication with partners, perceived greater partner and peer approval for condom use, and reported that peers also used condoms. Women in exclusive relationships evidenced earlier stage of change, lower intentions to use condoms, fewer peers who engaged in preventive behaviors, perceived themselves to have lower risk, and had lower rates of condom use, higher education, and family income. Women in fluid relationships were at particularly high risk, with lower rates of condom use relative to women not in a relationship and greater sexual risk for HIV. Implications for HIV-risk reduction interventions with African American women are discussed.

African American women condoms risk reduction HIV/AIDS 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bandura A. (1986). Social foundations of thought and action. Englewoods Cliffs, NJ: Prentice-Hall.Google Scholar
  2. Becker, M. H. (1974). The health belief model and personal health behavior. Health Education Monographs, 2, 324-473.Google Scholar
  3. Bressler, J., Armstrong, K., & McGrory, J. (1994, November). Communication workshops entice high risk men and women to safer sex programs. Paper presented at the annual meeting of the American Public Health Association, Washington, DC.Google Scholar
  4. Centers for Disease Control and Prevention. (1995). HIV/AIDS Surveillance Report, 1-33.Google Scholar
  5. Centers for Disease Control and Prevention. (1994b). AIDS among racial/ethnic minorities-United States, 1993. Morbidity and Mortality Weekly Report, 43, 644-647, 653–655.Google Scholar
  6. Centers for Disease Control and Prevention. (1994c). Heterosexually acquired AIDS-United States 1993. Morbidity and Mortality Weekly Report, 43, 155-160.Google Scholar
  7. Detzer, M. J., Wendt, S. J., Solomon, L. J., Dorsch, E., Geller, B. M., Friedman, J., Hauser, H., Flynn, B.S., & Dorwaldt, A. L. (1995). Barriers to condom use among women attending Planned Parenthood clinics. Women and Health, 23, 91-101.Google Scholar
  8. Dicks, B. A. (1994). African American women and AIDS: A public health/social work challenge. In B. A. Dicks (Ed.), Social work in health care (pp. 123-143). New York: Haworth.Google Scholar
  9. DiClemente, R. J., & Wingood, G. M. (1995). A randomized controlled trial of an HIV sexual risk-reduction intervention for young African American women. Journal of the American Medical Association, 274, 1271-1276.Google Scholar
  10. Eldridge, G. D., St. Lawrence, J. S., Little, C. E., Shelby, M. C., & Brasfield, T. L. (1995). Barriers to condom use and barrier method preferences among low-income African American women. Women and Health, 23, 73-89.Google Scholar
  11. Fishbein, M., & Azjen, I. (1985). Belief, attitude, intention and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.Google Scholar
  12. Fleisher, J. M., Senie, R. T., Minkoff, H., & Jaccard, J. (1994). Condom use relative to knowledge of sexually transmitted disease prevention, method of birth control, and past or present infection. Journal of Community Health, 19, 395-407.Google Scholar
  13. Fullilove, M. T., Fullilove, R. E., Haynes, K., Gross, S. (1990). Black women and AIDS prevention: A view towards understanding the gender rules. Journal of Sex Research, 27, 47-64.Google Scholar
  14. Geringer, W. M., Marks, S., Allen, W. J., & Armstrong, K. A. (1993). Knowledge, attitudes, and behavior related to condom use and STDs in a high risk population. Journal of Sex Research, 30, 75-83.Google Scholar
  15. Heckman, T. G., Sikkema, K. J., Kelly, J. A., Fuqua, R. W., Mercer, M. B., Hoffman, R. G., Winett, R. A., Anderson, E. S., Perry, M. J., Hoffman, R. A., Solomon, L. J., Wagstaff, D. A., Cargill, V., Norman, A. D., & Crumble, D. (1996). Predictors of condom use and human immunodeficiency virus test seeking among women living in inner-city public housing developments. Sexually Transmitted Diseases, 23, 357-365.Google Scholar
  16. Hinkle, Y. A., Johnson, E. H., Gilbert, D., Jackson, L., & Lollis, C. M. (1992). African American women who always use condoms: Attitudes, knowledge about AIDS, and sexual behavior. Journal of American Medical Women's Association, 47, 230-237.Google Scholar
  17. Hobfoll, S. E., Jackson, A. P., Lavin, J., Britton, P. J., & Shepherd, J. B. (1993). Safer sex knowledge, behavior, and attitudes of inner-city women. Health Psychology, 12, 481-488.Google Scholar
  18. Jemmot, L. S., & Jemmot, J. B. (1991). Applying the theory of reasoned action to AIDS risk behavior: Condom use among Black women. Nursing Research, 40, 228-234.Google Scholar
  19. Jemmott, J. B., Jemmot, L. S., Spears, H., Hewitt, N., & Cruz-Collins M. (1992). Self-efficacy, hedonistic expectations, and condom use intentions among inner-city Black adolescent women: A social cognitive approach to AIDS risk behavior. Journal of Adolescent Health Care, 13, 512-519.Google Scholar
  20. Jurich, J. A., Adams, R. A., & Schulenberg, J. E. (1992). Factors related to behavior change in response to AIDS. Family Relations, 41, 97-103.Google Scholar
  21. Kalichman, S. C., Hunter, T. L., & Kelly, J. A. (1992). Perceptions of AIDS susceptibility among minority and nonminority women at risk for HIV infection. Journal of Consulting and Clinical Psychology, 60, 725-732.Google Scholar
  22. Kalichman, S. C., Rompa, D., & Coley, B. (1996). Experimental component analysis of a behavioral HIV/AIDS intervention for inner-city women. Journal of Consulting and Clinical Psychology, 64, 687-693.Google Scholar
  23. Kauth, M. R., St. Lawrence, J. S., & Kelly, J. A. (1991). Reliability of retrospective assessments of sexual HIV risk behavior: A comparison of biweekly, three-month, and 12-month self-reports. AIDS Education and Prevention, 3, 207-214.Google Scholar
  24. Kelly, J. A., Murphy, D. A., Washington, C. D., Wilson, T. S., Koob, J. J., Davis, D. R., Ledezma, G., & Davantes, B. (1994). Effects of HIV/AIDS prvention groups for high-risk women in urban primary health care clinics. American Journal of Public Health, 84, 1918-1922.Google Scholar
  25. Kelly, J. A., St. Lawrence, J. S., Brasfield, T. L., & Hood, V. (1989). An objective test of AIDS risk behavior knowledge: Scale development, validation, and norms. Journal of Behavior Therapy and Experimental Psychiatry, 20, 227-234.Google Scholar
  26. Kline, A., Kline, E., & Oken, E. (1992). Minority women and sexual choice in the age of AIDS. Social Science and Medicine, 34, 447-457.Google Scholar
  27. Libbus, K. (1995). Women's beliefs concerning condom acquisition and use. Public Health Nursing, 12, 341-347.Google Scholar
  28. Mays, V. M., & Cochran, S. D. (1993). Ethnic and gender differences in beliefs about sex partner questioning to reduce HIV risk. Journal of Adolescent Research, 8, 77-88.Google Scholar
  29. Nyamathi, A., Bennet, C., Leake, B., Lewis, C., & Flaskerud, J. (1993). AIDS-related knowledge, perceptions, and behaviors among impoverished minority women. American Journal of Public Health, 83, 65-71.Google Scholar
  30. O'Donnell, L., Doval, S. A., Duran, R., & O'Donnell, C. R. (1995). Predictors of condom acquisition after an STD clinic visit. Family Planning Perspectives, 27, 29-33.Google Scholar
  31. Peterson, J. L., Catania, J. A., Dolcini, M. M., & Faigeles, B. (1993). Multiple sexual partners among blacks in high-risk cities. Family Planning Perspectives, 25, 263-267.Google Scholar
  32. Pinkerton, S. D., & Abramson, P. R. (1993). Evaluating the risks: A Bernoulli Process model of HIV infection and risk reduction. Evaluation Review, 17, 504-528.Google Scholar
  33. Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.Google Scholar
  34. Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.Google Scholar
  35. Quinn, S. C. (1993). AIDS and the African American woman: The triple burden of race, class, and gender. Health Education Quarterly, 20, 305-320.Google Scholar
  36. Richter, D. L., Sy, F. S., Mukhtar, Q., Addy, C. L., & Macera, C. A. (1992). Contraception and HIV prevention among women in public health clinics. Health Values, 16, 3-9.Google Scholar
  37. Sacks, V. (1996). Women and AIDS: An analysis of media misrepresentations. Social Science and Medicine, 42, 59-73.Google Scholar
  38. Shayne, V. T., & Kaplan, B. J. (1991). Double victims: Poor women and AIDS. Women and Health, 17, 21-37.Google Scholar
  39. Shervington, D. O. (1993). The acceptability of the female condom among low-income African American women. Journal of the National Medical Association, 58, 341-347.Google Scholar
  40. Smeltzer, S. C., & Whipple, B. (1991). Women and HIV infection. IMAGE: Journal of Nursing Scholarship, 23, 249-256.Google Scholar
  41. Sobo, E. J. (1993). Inner-city women and AIDS: The psychosocial benefits of unsafe sex. Culture, Medicine and Psychiatry, 17, 455-485.Google Scholar
  42. St. Lawrence, J. S. (1993). African American adolescents' knowledge, health-related attitudes, sexual behavior, and contraceptive decisions: Implications for the prevention of adolescent HIV infection. Journal of Consulting and Clinical Psychology, 61, 104-112.Google Scholar
  43. Torabi, M. R., & Yarber, W. (1992). Alternate forms of HIV prevention attitude scales for teenagers. AIDS Education and Prevention, 4, 172-182.Google Scholar
  44. Trussel, J., Sturgen, K., Strickler, J., & Dominik, R. (1994). Comparative efficacy of the female condom and other barrier methods. Family Planning Perspectives, 26, 66-72.Google Scholar
  45. Weeks, M. R., Schensul, J. J., Williams, S. S., Singer, M., & Grier, M. (1995). AIDS prevention for African American and Latina women: Building culturally and gender appropriate intervention. AIDS Education and Prevention, 7, 251-263.Google Scholar
  46. Wingood, G. M., & DiClemente, R. J. (1996). HIV sexual risk reduction interventions for women: A review. American Journal of Preventive Medicine, 12, 209-217.Google Scholar
  47. Zenilman, J. M., Weisman, C. S., Rompalo, A. M., Ellish, N., Upchurch, D. M., Hook, E. W., III, & Celentano, D. (1995). Condom use to prevent incident STDs: The validity of self-reported condom use. Sexually Transmitted Diseases, 22, 15-21.Google Scholar
  48. Zierler, S. (1994). Editorial: Women, sex, and HIV. Epidemiology, 5, 565-567.Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Janet S. St. Lawrence
    • 1
    • 2
  • Gloria D. Eldridge
    • 2
  • David Reitman
    • 2
  • Connie E. Little
    • 2
  • Millicent C. Shelby
    • 2
  • Ted L. Brasfield
    • 2
  1. 1.Centers for Disease Control and Prevention
  2. 2.Jackson State UniversityUSA.

Personalised recommendations