The data were
collected as part of the Supplement to HIV and AIDS Surveillance (SHAS) project, a Centers
for Disease Control and Prevention-funded project initiated in 13 state and county health
departments in the United States in January, 1990 (9). SHAS is a populationbased survey in
which all confirmed and living female AIDS cases reported in LAC are contacted to
participate in a detailed assessment of behavioral and sociodemographic characteristics.
In LAC, HIVinfected women who have not yet progressed to AIDS and who are receiving
medical treatment at the largest public HIV outpatient clinic in the county are also
included in SHAS. A confidential questionnaire is administered to all participants in
person by trained interviewers.
The goal of the analysis was to describe the sociodemographics and sexual and
drug-using behaviors of African-American women with HIV and AIDS in LAC and compare the
characteristics of this subgroup with those of women of other races with HIV and AIDS in
LAC. Univariate statistics, stratified by race, are presented for purposes of the
descnptive characterization. Odds ratios (OR) and 95% confidence intervals (CI) were
computed to examine whether African-American women with HIV and AIDS were more likely than
women of other races with HIV and AIDS to report certain behaviors and characteristics.
Student's l-tests were conducted to compare the mean age of African-American women with
that of women of other races. All analyses were conducted using SAS version 6.10 (10).
Using an a priori list of confounders, we examined the association between
each confounder, race, and behavioral or demographic characteristics. If strong
associations were present between the confounder and race and the confounder and the
characteristic, or prior information was present, the factor was considered a confounder
and controlled for in the analysis.
Data were analyzed both separately and in combination for HIVinfected women
and for those with AIDS to evaluate the impact that the aggregation of the two subgroups
had on validity and generalizability. Because the results for the two groups were not
significantly different, only the combined analyses are presented. Census data on the
annual household income in 1989 (11) for African-American households in LAC were compared
with the income distribution of the populationbased sample of Afacan-American women with
AIDS only, given that this subset is most representative of the general population.
In total, 1005
surviving women diagnosed with HIV or AIDS were eligible to participate in a SHAS
interview. Of these, 624 (62%) completed a questionnaire, including 379 (61%) who had been
diagnosed with AIDS and 245 (39%) who had been diagnosed with HIV infection but had not
yet progressed to AIDS.
This group of African-American women with HIV and AIDS tended
to be single parents (64%) who were unemployed (88%), and receiving public assistance
(86%). When compared with women of other races with HIV and AIDS, African-American women
were more likely to be single parents (OR = 1.6; 95% CI = 1.1, 2.4), reported receiving
public assistance more often (OR = 1.8; 95% CI = 1.1, 2.9) and were more apt to live
alone. African-American women were also more likely to delay seeking treatment for their
HIV infection beyond 6 months of learning of their infection (OR = 2.4; 95% CI = 1.4, 4.3;
A larger proportion of both African-American women (76%) and Latinas (80%)
reported annual household incomes of <$10,000 U.S. compared with the incomes of white
women (48%), although these differences were not statistically significant. Only 22% of
all AfricanAmerican households in LAC in 1989 reported annual household incomes
<$10,000 U.S. (11), compared with 72% among the African-American women with AIDS in the
With respect to high-risk sexual behaviors, 61% of African-American women
reported more than one male sexual partner in the last 5 years, a proportion that was
significantly higher than that for women of other races (OR = 2.3; 95% CI = 1.6, 3.4). Few
African-American women reported that they used a condom every time with their steady sex
partners in the year prior to learning of their HIV infection (6%); this finding was also
similar among all racial groups. An increased proportion of African-American women
reported consistent condom use with their steady sex partner after learning of their HIV
infection (37%); however, 35% reported inconsistent condom use following notification of
an HIV infection. When controlling for number of sexual partners, AfricanAmerican women
were also 2.0 times more likely to trade sex for drugs or money in the past 5 years (95%
CI = 1.2, 3.5; Table 2).
Regarding sexually transmitted disease (STD) history, African-American women
were twice as likely to report at least one STD in their lifetimes and had statistically
significantly higher reported lifetime histories of genital gonorrhea, syphilis,
nongonococcal urethritis, and pelvic inflammatory disease (Table 3).
In an analysis of injection drug use behaviors, 23% of African-American women
reported some lifetime injection drug use, a proportion that did not differ significantly
from women of other races. Heroin was the most commonly injected drug for
African-American, white, and Latino women; no substantial racial differences were found in
the most widely used drugs. Of the women who had ever injected drugs, African-American
women were most likely to have shared needles (95%), although this was not statistically
different from women of other races (OR = 3.7; 95% CI = 0.9, 16.1; Table 4).