Abstract
This report describes among 360 family planning clients in an HIV epicenter, women's HIV/STD risk characteristics, the barriers and facilitators of condom use within the context of relationships, and the use of alternative strategies for protection. Women attending the clinic were recruited for an HIV/STD preventive intervention and interviewed at baseline. At least 1 risk factor was reported by 77%, including a diagnosis of an STD within the last year for 30%. Recent STD diagnosis was associated with having a risky partner, but not with number of current partners. Women reporting consistent condom use had higher quality of couple communication, stronger intentions to prevent pregnancy, more positive reactions to condoms themselves and from their partners. Alternative risk reduction strategies, including using a barrier method other than condoms, refusing sex, engaging in nonpenetrative sex, leaving a relationship due to STD concerns, or undergoing mutual HIV testing had been used by 39% of women in the past 3 months.
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REFERENCES
Amaro, H. (1995). Love, sex, and power: Considering women's realities in HIV prevention. American Psychologist, 50, 437-447.
Bolan, G., Ehrhardt, A. A., and Wasserheit, J. N. (1999). Gender perspectives in STDs. In K. K. Holmes, P. Snarling, P. A. March, S. M. Lemon, W. E. Stamp, P. Picot, and J. N. Wasserheit (Eds.), Sexually transmitted diseases (3rd ed., pp. 117-127). NewYork: McGraw-Hill.
Cabral, R. J., Pulley, L. V., Artz, L. M., Brill, I., and Macaluso, M. (1998). Women at risk of HIV/STD: The importance of male partners as barriers to condom use. AIDS and Behavior, 2, 75-85.
Catania, J. A., Binson, D., Canchola, J., Pollack, L. M., Hauck, W., and Coates, T. J. (1996). Effect of interviewer gender, interviewer choice, and item wording on responses to questions concerning sexual behavior. Public Opinion Quarterly, 60, 345-375.
Catania, J. A., Coates, T. J., Stall, R., Turner, H., Peterson, J., Hearst, N., et al. (1992). Prevalence of AIDS-related risk factors and condom use in the United States. Science, 258, 1101-1106.
Catania, J. A., Kegeles, S. K., and Coates, T. J. (1990). Towards an understanding of risk behaviors: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 53-72.
Cates, W., Jr., and Stone, K. M. (1992). Family planning, sexually transmitted diseases and contraceptive choice: A literature update-Part I. Family Planning Perspectives, 24, 75-84.
Cecil, H., Perry, M. J., Seal, D. W., and Pinkerton, S. D. (1998). The female condom: What we have learned thus far. AIDS and Behavior, 2, 241-256.
Centers for Disease Control and Prevention. (1995). Update:AIDS among women-United States, 1994. Morbidity and Mortality Weekly Report, 44, 81-84.
Centers for Disease Control and Prevention, Division of STD Prevention. (1999). Sexually Transmitted Disease Surveillance, 1998. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
Centers for Disease Control and Prevention. (2000). HIV/AIDS Surveillance Report, 1999 (Vol. 11). Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.
Coates, T. J., Stall, R. D., Catania, J. A., and Kegeles, S. M. (1988). Behavioral factors in the spread of HIV infection. AIDS, 2, 239-242.
Cochran, S. D., and Mays, V. M. (1993). Applying social psychological models to predicting HIV-related sexual risk behaviors among African Americans. Journal of Black Psychology, 19, 142-154.
Currie, D. (1988). Re-Thinking what we do and how we do it: A study of reproductive decisions. Canadian Review of Sociology and Anthropology, 25, 231-253.
DeVincenzi, I., for the European Study Group on Heterosexual Transmission of HIV. (1994). A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine, 331, 341-346.
Dolcini, M. M., Catania, J. A., Coates, T. J., Stall, R., Hudes, E. S., Gagnon, J. H., and Pollack, L. M. (1993). Demographic characteristics of heterosexuals with multiple partners: The National AIDS Behavioral Surveys. Family Planning Perspectives, 25, 208-214.
Ehrhardt, A. A., and Exner, T. M. (1991). The impact of HIV infection on women's sexuality and gender role. In S. J. Blumenthal, A. Eichler, and G. Weissman (Eds.), Women and AIDS:Promoting healthy behaviors (pp. 36-40). Rockville, MD: U.S. Department of Health and Human Services.
Ehrhardt, A. A., Yingling, S., Zawadzki, R., and Martinez-Ramirez, M. (1992). Prevention of heterosexual transmission of HIV barriers for women. Journal of Psychology and Human Sexuality, 5, 37-67.
Erickson, P. I., Bastani, R., Maxwell, A. E., Marcus, A. C., Capell, F. J., and Xan, K. X. (1995). Prevalence of anal sex among heterosexuals in California and its relationship to other AIDS risk behaviors. AIDS Education and Prevention, 7, 477-493.
Exner, T. M., Meyer-Bahlburg, H. F. L., Yingling, S. L., Hoffman, S., Ortiz-Torres, B., and Ehrhardt, A. A. (1994). Psychosexual and psychosocial interviews for Project FIO (The Future is Ours). Unpublished, Columbia University, Department of Psychiatry, New York.
Exner, T. M., Seal, D.W., and Ehrhardt, A. A. (1997). A review of HIV interventions for at-risk women. AIDS and Behavior, 2, 93-124.
Ezeh, A., Seroussi, M., and Raggers, H. (1996). Men's fertility, contraceptive use, and reproductive preferences. DHS comparative studies, No. 18. Calverton, MD: Macro International Inc.
Fullilove, M. T., Fullilove, R. E., Haynes, K., and Gross, S. (1990). Black women and AIDS prevention: A view towards understanding the rules. The Journal of Sex Research, 27, 47-64.
Gollub, E. L., French, P., Loundou, A., Latka, M., Rogers, C., and Stein, Z. (2000). A randomized trial of hierarchical counseling in a short, clinic-based intervention to reduce the risk of sexually transmitted diseases in women. AIDS, 14, 1249-1255.
Gómez, C. A., and VanOss Marín, B. (1996). Gender, culture and power: Barrier to HIV-prevention strategies for women. The Journal of Sex Research, 33, 355-362.
Hobfoll, S. E., Jackson, A. P., Lavin, J., Britton, P. J., and Shepherd, J. B. (1993). Safer sex knowledge, behavior, and attitudes of inner-city women. Health Psychology, 12, 481-488.
Hobfoll, S. E., Jackson, A. P., Lavin, J., Britton, P. J., and Shepherd, J. B. (1994). Women's barriers to safer sex. Psychology and Health, 9, 233-252.
Ickovics, J. R., and Yoshikawa, H. (1998). Preventive interventions to reduce HIV risk for women: Current perspectives, future directions. AIDS, 12, S197-S208.
Lansky, A., Thomas, J. C., and Earp, J. (1998). Partner-specific sexual behaviors among persons with both main and other partners. Family Planning Perspectives, 30, 93-96.
Latka, M., Gollub, E., French, P., and Stein, Z. (2000). Male-condom and female-condom use among women after counseling in a risk-reduction hierarchy for STD prevention. Sexually Transmitted Diseases, 27, 431-437.
Meyer-Bahlburg, H. F. L., and Gruen, R. S. (1992).Training Manual for Psychosexual Interviewing. Unpublished, Columbia University, Department of Psychiatry, New York.
National Institute of Allergy and Infectious Disease and the Heterosexual HIV Adult Transmission Study. (1991). Heterosexual Adult Transmission Study (HATS) Interviews. Unpublished research instruments. Bethesda, MD.
NewYork City Department of Health, Office of AIDS Surveillance. (1999). AIDS Surveillance Update, First Quarter 1999.
New York State Department of Health, AIDS Institute. (1992). Methods of personal protection for women to reduce transmission of HIV through vaginal intercourse: Policy statement. Albany, NY.
Nicolosi, A., Leite, M. L. C., Musicco, M., Arici, C., Gavazzeni, G., and Lazzarin, A. (1994). The efficiency of male-to-female and female-to-male sexual transmission of the human immunodeficiency virus: A study of 730 stable couples. Epidemiology, 5, 570-575.
Richter, D. L., Sy, F. S., Mukhtar, Q., Addy, C. L., and Macera, C. A. (1992). Contraception and HIV prevention among women in public health clinics. Health Values, 16, 3-9.
Rosenberg, M. J., and Gollub, E. L. (1992). Commentary. Methods women can use that may prevent sexually transmitted disease, including HIV. American Journal of Public Health, 82, 1473-1478.
Stone, K. M., Grimes, D. A., and Magder, L. S. (1986). Personal protection against sexually transmitted diseases. American Journal of Obstetrics and Gynecology, 155, 180-188.
Trussell, J., Sturgen, K., Strickler, J., and Dominik, R. (1994). Comparative contraceptive efficacy of the female condom and other barrier methods. Family Planning Perspectives, 26, 66-72.
Wingood, G., and DiClemente, R. (1992). Cultural, peer, and psychosocial influences on HIV-related behavior of African-American female adolescents: Implications for the development of tailored HIV prevention programs. Ethnicity and Diseases, 3, 381-386.
Wingood, G. M., and DiClemente, R. J. (1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 87, 1016-1018.
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Ehrhardt, A.A., Exner, T.M., Hoffman, S. et al. HIV/STD Risk and Sexual Strategies Among Women Family Planning Clients in New York: Project FIO. AIDS Behav 6, 1–13 (2002). https://doi.org/10.1023/A:1014534110868
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DOI: https://doi.org/10.1023/A:1014534110868