Psychological and social factors associated with histories of risk for human immunodeficiency virus infection among African-American inner-city women.

Minority women constitute the fastest-growing segment of the American epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The present study examined the psychological and social factors related to HIV risk among 153 African-American inner-city women who completed measures of HIV risk history, sexual and substance use behaviors, perceived risk for HIV infection, self-efficacy to reduce risk (belief that one can effectively perform specific behaviors), and perceived social norms supporting risk reduction. Fifty-five percent of the women (n = 84) reported at least one factor that had placed them at known risk for HIV infection. Results of a stepwise regression analysis showed that HIV risk history was associated with self-perceived risk for HIV infection and self-efficacy to perform risk-reducing actions. Social norms for safer sex did not contribute significantly to the explained variance. Women at risk were more likely to have been forced or coerced into unwanted sex and were less likely to have been familiar with their most recent sex partner. These result suggest that HIV risk-reduction interventions targeting inner-city women should focus on skills training approaches to build self-efficacy and empower women to adopt risk-reducing practices.