CHARACTERlSTlCS OF AFRICAN-AMERICAN WOMEN WITH HIV AND AIDS                                                             419

TABLE 5. Noninjection drug use in women with HIV and AIDS interviewed
in Los Angeles County, 199-1997


Race/ethnicity of women

Black White Latina Other
No. % No. % No. % No. %
Behavior (n =168) (n = 87) (n = 357) (n =12) OR 95% Cl
Noninjection drug use in past 5 years
   Yes 93 55 45 52 57 16 2 17 3.3b 2.2 4.9
   No 75 45 42 48 300 84 10 83
Non-injection drugs used in past 5 yearsc
   Heroin 21 23 11 24 23 40 0 0.6 0.3 1.1
   Cocaine (snorting and free basing) 51 55 25 56 44 77 1 50 0.6 0.3 1.1
   Crack (smoking) 69 74 14 31 31 54 1 50 3.5b 1.9 6.4
   Valium 11 12 8 18 15 26 2 100 0.4 0.2 0.9
   PCP, LSD-Hallucinogenics 7 8 6 13 10 18 0 0.4 0.2 1.1
   Barbiturates 5 5 10 22 7 12 0 0.3 0.1 0.8
   Marijuana, hashish, or THC 65 70 32 71 34 60 2 100 1.2 0.7 2.2
   Speed 5 5 15 33 13 23 1 50 0.1 0.1 0.4
Ever used crack cocaine?.
   Yes 84 50 26 30 40 11 1 8 4.7b 3.2 7.1
   No 83 49 61 70 317 89 11 92
   Refused to answer I 1 0 0 0
Ever used crack in a crack house?d
   Yes 39 46 10 38 10 25 1 100 1.7b 0.9 3.4
   No 45 54 16 62 30 75 0
Ever had sex in a crack house when using crack?e
   Yes 17 44 3 30 5 50 0 1.1b 0.3 3.3
   No 22 56 7 70 5 50 1 100

OR, odds ratio; CI, confidence interval; PCP, phencyclidine; LSD, Iysergic acid diethylamide; THC, tetrahydrocannabinol.
a The OR and 95% Cls were calculated comparing African-American women with women of all other races.
b Adjusted OR controlling for number of sexual partners in the last 5 years.
c The totals for this analysis includes persons who have practiced non-injection drug use in the past 5 years.
d The totals for this analysis includes persons who have used crack cocaine.
e The totals for this analysis includes persons who have used crack cocaine in a crack house.

 users demonstrated that despite a high level of understanding regarding HIV transmission, HIV/AIDS education efforts largely failed and high-risk sexual hehaviors continued (6,7). Clearly, education alone iS not sufficient for preventing HIV infection in African-American women in LAC, hut that client-centered programs that are based on a "contextual" model (3) that incorporates the disadvantaged circumstances of these women, including the culture of crack cocaine, will he considerably more effective. These interventions must include assistance to Afr~can-American women in developing selfesteem and the skills necessary to negotiate safer hehavior in their sexual relationships with men.
   Acknowledgments:
We would like to acknowledge the following persons for their contribution to this work: Theresa Diaz, Allyn Nakashima, and Bernard Nahlen, U.S. Centers for Disease Control and Prevention; and Maribel Castillon, Lucia Iglesias, Paul Simon, Gordon Bunch, Trista gingham, Chris Rosales, and Kai-Jen Cheng, Los Angeles County HIV Epidemiology Program.

REFERENCES

1. HIV Epidemiology Program, Los Angeles County Department of Health Services. Advanced HIV Disease (AIDS) Surveillance Summary Apnl 15, 1997: 1-23.
2. Johnson EH, Jackson LA, Hinkle Y, et al. What is the significance of black-white differences in risky sexual behavior? J Natl Med Assoc 1994;86:745-59.

3. Lester B. The social context of HIV transmission in the AfricanAmerican community. Ethnicity and Disease 1993;3:387-94.
4. Nyamathi A. Psychosocial predictors of AIDS risk behavior and drug use behavior in homeless and drug addicted women of color. Health Psychology 1995;14:265-73.
5. Brunswick AF, Aidala A, Dobkin J, Howard J, Titus SP, Banaszak-Holl J. HIV seroprevalence and risk behaviors in an urban African-American community cohort. Am J Public Health 1993; 83:1390 4.
6. Hetherington SE, Harris RM, Bausell RB, Kavanagh KH, Scott DE. AIDS prevention in high-risk African-American women: behavioral, psychological and gender issues. J Sex Marital Ther 1996;22:9-21.
7. Hams RM, Kavanagh KH. Perception of AIDS nsk and high-risk behaviors in African-American methadone-dependent women. AIDS Educ Prev 1995;7:415-28.
8. Nyamathi A. Comparative study of factors relating to HIV risk level of black homeless women. J Acquir Immune Defic Syndr 1992;5:222-8.
9. Diaz T, Chu S, Conti L, et al. Risk behaviors of persons with heterosexually acquired HIV infection in the United States: results of a multistate surveillance project. J Acquir Immune Defic Syndr 1994:7:958 63.
10. SAS, V. 6.10. Cary, NC: SAS, 1994.
11. U.S. Bureau of the Census, 1990 social and economic characteristics for California, CP2 .

Journal of Acquired Immune Def ciency Syndromes and Human Retrovirology, Vol. 19, No. 4, December 1, 1998

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