This study was conducted among predominately African American/Black women, aged 18-29, in Northeast cities with high HIV prevalence. Demographic, behavioral, and partner characteristics associated with condomless vaginal and anal sex acts with high-risk partners (CVS-HRP and CAS-HRP) and with HIV testing were explored. The high-risk sample was largely recruited online. Of 4972 women screened, 2254 (45.3%) were high-risk for HIV acquisition; 2214 were included. Bivariate and stepwise multivariate logistic regression models were fit. After adjusting for other factors, sex risk behavior did not differ by race and ethnicity. CAS-HRP was associated with believing condoms don't reduce HIV risk and with several high-risk behaviors, including; alcohol use, multiple partners, and sex with men who had sex with men, but, not with HIV testing. Half the sample had condomless sex with partners who never HIV tested and were themselves three times as likely to have never tested. These results point to the ongoing need for effective prevention strategies among at-risk heterosexual women.
Keywords: Black women; Condomless vaginal and anal sex; HIV prevention; HIV risk behavior; HIV testing.