THE INFLUENCE OF PSYCHOSOCIAL FACTORS, ALCOHOL, DRUG-USE ON AFRICAN-AMERICAN WOMENS HIGH-RISK SEXUAL-BEHAVIOR

Objectives: The present study examines psychosocial and behavioral inf luences, particularly drug and alcohol use, as correlates of inconsist ent condom use and having multiple sexual partners during the past mon th among African-American women. Methods: This cross-sectional study, conducted between May and June 1996, recruited a convenience sample of 180 African-American women in Birmingham, Alabama. Women completed a face-to-face interview that assessed alcohol and drug use, sexual beha viors, depression, condom use, and negotiation skills. Results: The ma jority of women, 51.6% (n = 93), had used either alcohol or drugs duri ng the previous month. Many women, 31.1%, consumed alcohol, 18.3% used marijuana, and 8.3% had smoked crack within the past month. Nearly 42 .7% of women used condoms inconsistently in the past month and 13.3% o f women had multiple sexual partners within the past month. A logistic regression model predicting inconsistent condom use indicated that wo men were less likely to use condoms if they consumed alcohol between 2 0 and 30 days of the month (OR = 2.8, 90% CI = 1.3-5.9) and if they ha d not negotiated condom use (OR = 32.4, 90% CI = 7.9-131.6). The logis tic regression model predicting multiple sexual partners indicated tha t women were more likely to have multiple sexual partners if they had smoked crack in the past month (OR = 5.3, 90% CI = 1.6-18.2). Conclusi ons: HIV sexual risk-reduction interventions for African-American wome n need to address the overlapping epidemics of drugs, alcohol, and STD s. Additionally, HIV sexual risk reduction efforts should be incorpora ted into existing drug and alcohol treatment programs and STD clinics.