THE ASSOCIATION BETWEEN SUBSTANCE USE, CONDOM USE AND SEXUAL RISK AMONG LOW-INCOME WOMEN

Substance use is frequently assumed to be associated with higher level s of sexual risk-faking and lower levels of condom use. An analysis of 668 black, Hispanic and white low-income women at public health and p ublic assistance facilities in Miami shows that 19% engaged in risky s exual behavior over the preceding six months, 24% in substance use and 31% in condom use. Overall, substance users are nearly four and one-h alf times more likely to take sexual risks than nonusers, but are abou t half as likely to have relied on condoms. When the probability of co ndom use is considered in the context of both substance use and sexual risk, substance users who take sexual risks appear just as likely to rely on condoms as are nonusers who take sexual risks and those who do not (odds of 0.43-0.49). However, substance users who do not take sex ual risks are much less likely to use condoms (odds of 0.15). This pat tern holds among black, Hispanic and white women, and suggests that pe rceptions of risk and the risks that partners bring to sexual encounte rs may be more important determinants of condom use than substance use per se.