Ethnicity, serostatus, and psychosocial differences in sexual risk behavior among HIV-seropositive and HIV-seronegative women

Abstract

Childhood sexual abuse and related life traumas, and other psychosocial variables were investigated as contributors to ethnic differences in sexual risk behaviors among women who differed in HIV-serostatus. A multiethnic sample of 457 HIV-positive and HIV-negative women residing in Los Angeles county was recruited and studied over 2 years as part of the UCLA-Charles R. Drew University Women and Family Project (WFP) study. Comprehensive interviews were administered to participants by ethnically- and linguistically matched interviewers. Data on demographic information, sexual trauma, substance abuse/dependence, psychiatric distress, and sexual history and risk behaviors were collected. The sample for these analyses consisted of 155 African American, 153 European American, and 149 Latina women, and nearly two-thirds of the sample was HIV-seropositive. HIV-positive women were significantly more likely to report more posttraumatic stress, chronic stress, negative health behaviors, drug use, and psychiatric history than HIV-negative women. European American and African American women were more likely to report a history of sexual trauma than Latina women. Finally, Poisson regression analyses revealed that history of trauma, ethnicity, drug and alcohol use, homelessness, and being HIV-positive were associated with greater likelihood of engaging in high-risk sexual behaviors, with history of trauma increasing the likelihood of engaging in high-risk behaviors by 5.1%. These findings highlight important differences among women as a function of ethnicity and HIV status, and underscore the need for special services for HIV-positive women that address the risk-enhancing effects of substance abuse/dependence, homelessness, and sexual trauma.