Finance, Romance, Social Support, and Condom Use among Impoverished Inner-City Women

Qualitative and quantitative research conducted among low-income inner-city predominantly African-American women indicated that in this population gender roles and romantic ideals about heterosexual relationships are more significant than economic factors in contributing to human immunodeficiency virus (HIV) risk behaviors. The analysis based on questionnaires administered to 30 clients at a maternal-infant health care clinic in the Midwest was supplemented by discussions with an additional 25 clinic patients. 17 (59%) of respondents and 25 (72%) of discussants had not used condoms during their most recent sexual encounter. Unprotected intercourse was most prevalent among socially isolated unemployed women whose self-esteem emotional fulfillment and social status were derived primarily from conjugal partnerships. Although condom nonusers were more likely than users to receive food and help with household expenses from their male partners financial dependence on men was negligible; employment or public assistance were more reliable income sources. The psychological benefits associated with being in a relationship were primary. Condom use--associated by these women with infidelity and deception--was rejected in order to preserve romantic ideals. Women who reported no social support from friends or relatives were most likely to deny the risks of HIV associated with unsafe sex given their emotional dependence. This studys finding of the centrality of social and emotional factors in womens sexual behavior contrasts with the hegemonic model that attributes womens unsafe sex practices to financial coercion.