We examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likely to receive AFDC, twice as likely to be sexually nonassertive, three times more likely to believe that it was not difficult to find an "eligible" African American man, and three times as likely to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.
PIP: Reducing the high rate of HIV/AIDS among African American women requires attention to the factors associated with nonuse of condoms. This study assessed the relationship between gender-related factors, partner influences, and nonuse of condoms in a community-based sample of 128 African American women 18-29 years old from a low-income neighborhood in San Francisco, California (US). The Theory of Gender and Power, which uses the division of labor, the structure of power, and the structure of cathexis to characterize relationships between men and women, guided the analysis. 45.3% of respondents never used condoms in the 3 months preceding the survey. Seven variables correctly classified 78.7% of respondents into their actual condom use category. Women were more likely not to use condoms if they believed that asking their sexual partner to use a condom implied he was unfaithful (odds ratio [OR], 4.30; 95% confidence interval [CI], 1.30-14.3); if they had a partner who resisted condom use (OR, 3.4; 95% CI, 1.25-9.07); if they did not appreciate having their partner ask them to use condoms (OR, 3.10; 95% CI, 1/12-8.65); if Aid to Families with Dependent Children was their main source of income (OR, 3.3; 95% CI, 1.01-10.67); if they were not sexually assertive in demanding that their partner use a condom (OR, 2.6; 95% CI, 1.03-6.78); if they believed that it was not difficult to find an "eligible" African American man (OR, 2.94; 95% CI, 1.17-10.11); and if they had 1 sexual partner in the past 3 months (OR, 3.5; 95% CI, 1.22-15.57). These findings suggest that interventions that modify women's perceptions of the social norms that govern gender relationships and impart skills that increase their ability to negotiate condom use are needed to reduce the HIV risk of young African American women.