Gender, culture, and power: Barriers to HIV‐prevention strategies for women

Abstract

The rapid increase of HIV infection among women in the U.S. has been attributed primarily to sexual contact with HIV‐infected men. Strong cultural gender norms regarding sexual behaviors among Latinos exacerbates this risk for Latino women. In this study we assessed contraceptive use patterns and predictors of condom use with steady male partners among a random sample of 513 Latino and 184 non‐Latino White women (N = 697). The women were assessed for ethnic differences in sexual behaviors and psychosocial variables using t‐tests. We used multiple regression analysis to assess predictors of condom use with steady male partners for all women. Although Latino and non‐Latino White women differed significantly on most psychosocial factors, predictors of condom use were the same for the two groups: positive attitude about condom use, not using other forms of contraception, belief that friends use condoms, self‐efficacy to use condoms, more sexual power (i.e., less concern that the male partner would become angry or violent at condom use request), worry about contracting HIV, and reporting two or more partners in the year prior to the interview. Non‐Latino White women had better knowledge about HIV, more sexual comfort, more self‐efficacy in using condoms, and more sexual power than did Latino women. To be safe from HIV infection, heterosexual women must rely not only on their own skill, attitude, and efficacy concerning sexual behaviors and condom use, but also on their ability to convince their sexual partner to use a condom. HTV‐prevention strategies must target heterosexual couples and address gender norms in sexual behavior decision making, regardless of a person's ethnicity.