Correlates of Consistent Condom Use Among HIV-Positive African American Women

INTRODUCTION: African American women are the fastest growing group at risk of contracting HIV, as over 68% of women diagnosed with HIV are African American. The present study used social-cognitive theory and the theory of gender and power to identify correlates of consistent condom use among African American women living with HIV. METHODS: We recruited 366 women, 18-50 years of age and living with HIV from several HIV/AIDS clinics in the southeastern United States. The majority of women, 84.2% (N = 308), were African American. Women completed a baseline interview assessing sociodemographic, psychosocial, and partner-related factors potentially associated with consistent condom use, defined as reported use of condoms during every vaginal sex episode with a male sexual partner in the past 30 days. RESULTS: Among those HIV-positive African American women reporting use of a condom in the past 30 days (n = 234, 70%), consistent condom use was reported by 67.1% of women. This rate was lower (51.6%) among women having an HIV-positive male sexual partner; the rate was higher (74.1%) among women having an HIV-negative male sexual partner. Compared to women who were inconsistent condom users, women with HIV were more likely to use condoms if they: had high partner communication self-efficacy (OR = 7.77, 95% CI = 3.3-18.6, p = .001), had a HIV-negative male sex partner (OR = 4.62, 95% CI = 1.9-11.5, p = 0.001), had low partner-related barriers to condom use (OR = 4.68, 95% CI = 1.8-12.2, p = 0.001), and had perceived peer norms supportive of condom use (OR = 2.38, 95% CI = 1.0-5.7, p = 0.03). CONCLUSION: These findings suggest that HIV interventions may enhance consistent condom use among African American women living with HIV by targeting women's self-efficacy to communicate with their partners and women's perception of personal and partner-related barriers to condom use.