Proximal and distal predictors of AIDS risk behaviors among inner-city African American and European American women

AIDS risk behavior and attitudes towards safer sex were studied in a sample of 666 African American and 626 European American women. Condom use, AIDS- related knowledge, risk perception, self-efficacy beliefs, attitudes and pe rceived partner attitudes, and an assertive coping style were analyzed with regard to mean differences and predictive power in both ethnic groups. Com pared to European American women, African American women had less knowledge and lower self-efficacy beliefs towards safer sex behavior, but they perce ived themselves to be at more risk and reported greater condom use. Further , ethnicity was found to moderate the effects of the psychological predicto rs on safer sex behavior. This moderator effect was tested using a structur al equation modeling design. In both groups, risk perception was the strong est predictor of condom use. Among African American women, social-cognitive barriers (e.g. low self-efficacy beliefs, negative attitude towards condom use) worked as a second predictor and mediator of the effects of risk perc eption on condom use. In contrast, among European American women, social-co gnitive factors had no effect on condom use. In general, prediction of safe r sex behavior was stronger among African American women.