Understanding the context of sexual risk behaviors among rural African American women stimulant users and their perceived risk of acquiring HIV

Wright T, Stewart KE, Booth BM. Understanding the context of sexual risk behaviors among rural African American women stimulant users and their perceived risk of acquiring HIV. Paper presented at: American Public Health Association Annual Meeting and Exposition; 2006 Nov 4; Boston, MA.

Objective: To examine the context of sexual risk behavior among rural African American stimulant-using women and their HIV risk perceptions. Significance: The prevalence of HIV/AIDSS in the Southern US is high among rural African Americans, especially women. Stimulant use has strong association with increase HIV risk. However, we know little about stimulant use and HIV among rural African Americans. By understanding the context of sexual risk behavior among rural African American stimulant-using women and their perceived risk for acquiring HIV, we can develop culturally appropriate intervetnions that incoprate these perceptions and possible decrease HIV incidence in this under-served population. Methods: Ethnographic interviews were conducted with 12 African American womed age 18-47 from twu rural Arkansas communities. All used cocaine within the past 30 dyas. Interviews were audiotaped, transcribed, verified for accuracy, and entered into Ethnograph 5.0 software for analysis. A codebook was developed and content analysis and constant comparisons were used to code all subsequent transcripts. Results: Four major themes emerged: knowledge and beleifs anout HIV, realtionships, life-style, and self-image. Preliminary results indicate rural African American female stimulant users are knowledgeable about HIV transmission and know that practicing safe sex decreases their risk of exposure. Although participants acknowledged their personal risk with deep concern, knowledge was not enough to prevent them from "taking a chance" by engaging in high-risk sexual activities. These activities were influenced by their drug use, financial needs, and emotional needs. Conclusion: There are significant personal, cultural, and environmental factors that are important to understanding HIV prevention among rural African Americam stimulant-using women.