CHARACTERISTICS
OF AFRICAN-AMERICAN WOMEN WITH HIV AND AIDS
417
Table 3. History
of Selected Sexually Transmitted Diseases (STD's) and Related Variables
in Women with HIV and AIDS Interviewed in Los Angeles County, 1990-1997
Race/Ethnicity of Women |
|
Black |
White |
Latina |
Other |
|
|
Characteristic |
(n =168) |
(n =87) |
(n
=357) |
(n =12) |
ORa |
95% |
CI |
| Genital Gonorrhea |
54 |
32 |
18 |
21 |
33 |
9 |
1 |
8 |
3.7 |
2.4 |
5.6 |
| Syphilis |
28 |
17 |
7 |
8 |
28 |
8 |
1 |
8 |
2.3 |
1.4 |
3.9 |
| Genital Warts |
24 |
14 |
17 |
20 |
35 |
10 |
2 |
17 |
1.2 |
0.7 |
2.1 |
| Non-gonococcal
Urethritis |
40 |
24 |
16 |
18 |
37 |
10 |
3 |
25 |
2.2 |
1.4 |
3.5 |
| Genital Herpes |
30 |
18 |
26 |
30 |
49 |
14 |
1 |
8 |
1.1 |
0.7 |
1.7 |
| Pelvic
Inflammatory Disease |
22 |
13 |
11 |
13 |
16 |
4 |
3 |
25 |
2.1 |
1.2 |
3.8 |
| Yes |
111 |
66 |
60 |
69 |
145 |
41 |
7 |
58 |
2.2 |
1.6 |
3.2 |
| No |
57 |
34 |
27 |
31 |
212 |
59 |
5 |
42 |
| In past 10 years, number of
visits to physician for STD |
| >=2 |
55 |
33 |
20 |
23 |
59 |
17 |
1 |
8 |
| 1 |
20 |
12 |
11 |
13 |
34 |
10 |
1 |
8 |
| 0 |
93 |
55 |
56 |
64 |
263 |
74 |
10 |
83 |
| Unknown |
0 |
- |
0 |
- |
1 |
0 |
0 |
- |
| Odds Ratio1
comparing >=1 to 0 visits:2.0; 95% CI's:1.4, 3.3 |
| In past 10 years, seen at
public VD or STD clinic? |
| Yes |
66 |
39 |
25 |
29 |
92 |
26 |
1 |
8 |
1.9 |
1.3 |
2.7 |
| No |
102 |
61 |
62 |
71 |
265 |
74 |
11 |
92 |
OR, odds ratio; CI, confidence interval;
VD, venereal disease; STD, sexually transmitted disease.
aOdds Ratios and 95% CI's were calculated comparing African-American
women to women of all other races.
likely that many
of these African-American women delay seeking health care because of other pressing
concerns, such as providing housing, food, and transportation for their families and for
themselves (3).
The preponderance of multiple male sexual partners and low rates of condom
use prior to learning of an HIV infection among the African-American women with HIV and
AIDS is also consistent with Namathi's study of high-risk African-American homeless women
in Los Angeles in which almost one third participated in vaginal sex with men without the
use of condoms (8). The increase in consistent condom use following the notification an
HIV infection among all racial groups of women in this study population is encouraging.
However, approximately one third to one quarter of the women in all racial groups did not
always use a condom following notification of their HIV infection. Low rates of condom use
in the African-American community has been attributed to a sense of powerlessness and lack
of personal control in sexual relationships with men (2,6). When the association between
race and trading sex for drugs or money is controlled for crack use in addition to to
number of sexual partners, the association between African-American race and trading sex
disappears, suggesting that trading sex in in African-American women is explained in part
by crack use. This finding is consistent with data on high-risk homeless women in LAC
among |
whom sex for
drugs or money, an established marker of risky sexual behavior, was more common among
African -American women (4,8).
The more common lifetime history of genital gonorrhea, syphilis,
nongonococcal urethritis, and pelvic inflammatory disease for African-American women is
consistent with STD surveillance data for LAC and elsewhere reporting a higher incidence
of these STD's in African-American women compared with women of other races (16). STD's
play a critical role in amplifying HIV transmission (17) and may be an important factor in
the local dynamics of HIV, particularly among African-Americans. A study among
HIV-infected women in LAC found a high rate of Trichomanas vaginalis infection
and a strong association with the African-American race (18).
Injection drug use was not more common among the African-American women
compared with women of other races, a finding supported by research in black homeless
women in Loa Angeles in which more than half of the women reported non-injection drug use
(8). The finding of more sharing of needles or syringes among black women is consistent
with needle-sharing practices studied among IDU's in a methadone treatment program in the
Bronx, New York (19).
An important finding from this research is the disproportionately high
frequency of reported crack use among African-American women with HIV and AIDS. |
Journal
of Acquired Immune Deficiency Syndromes and Human Retrovirology, Vol 19, No. 4, December
1, 1998
|