Predictors of HIV behavior in African-American, non-injection drug dependent women: A preliminary test of the AIDS risk reduction model

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael Antoni - Committee Chair


The AIDS Risk Reduction Model (ARRM) was used to investigate Human Immunodeficiency Virus (HIV) risk among socioeconomically disadvantaged, heterosexual, non-injection drug dependent, African American women attending inpatient substance abuse treatment. Subjects (N = 80) completed a structured interview protocol measuring ARRM mediating variables and HIV risk behaviors. High levels of sexual risk were shown, including infrequent condom use, non-monogamous sex, repeated sexually transmitted diseases, high rates of exchanging sex for money and drugs, and recurrent use of alcohol and other drugs proximal to sex. Preliminary support was provided for the use of the ARRM to predict HIV risk behaviors among this sample, although psychosocial and other extra-treatment factors not included in the ARRM (e.g., indigence, depression, using alcohol and other drugs proximal to sex) were typically better predictors. Most subjects failed to label their behavior as placing them at risk for contracting HIV, and were thus at a "pre-Labeling" ARRM stage. Higher perceived risk of contracting HIV infection in the 30 days prior to admission, more frequently exchanging sex for drugs, and lower socioeconomic status (SES) significantly predicted having more sexual partners in the 30 days prior to admission, collectively accounting for 51% of the variance. When a variable assessing the use of alcohol and other drugs proximal to sex was entered into the equation, lower SES, more education, more often using alcohol and other drugs proximal to sex, and greater labeling of personal risk was associated with having more sex partners, explaining 54% of the variance. More frequent sexual communication with the primary sex partner and higher SES differentiated condom users from nonusers. Women with more sex partners and those exchanging sex for money were also more likely to use condoms. HIV prevention interventions among this sample should focus on instilling accurate perceptions of risk, reinforcing substance abstinence, and building relevant abilities (e.g., sexual negotiation skills with partners). Couple-focused interventions may be particularly effective in reducing HIV risk related to infrequent condom use in committed relationships. Providing socioeconomically disadvantaged minority women with job training and placement opportunities to lessen financial dependence on committed and commercial sex partners may also be instrumental in reducing HIV risk.


Health Sciences, Public Health; Psychology, Clinical

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