Rape among African American women: sexual, psychological, and social correlates predisposing survivors to risk of STD/HIV.

The aim of this study was to examine the association of rape of adult African American women and sexual, psychologic, and social factors that predispose them to risks of sexually transmitted diseases, including human immunodeficiency virus (HIV). This cross-sectional study, conducted between February and December 1993, recruited 165 African American women, 18-29 years of age, from an African American community of low socioeconomic status in San Francisco, California. Women completed a face-to-face interview. The prevalence of adult rape (rape experienced after age 15) in this sample was 14%. Compared with women who did not report a history of adult rape, women who reported such a history were significantly more likely to report HIV-related sexual, psychologic, and social experiences. Specifically, adult rape survivors were nearly 6 times more likely to have had sex 10 or more times in the past 3 months, 3 times as likely to report never using condoms during the past 3 months, 3.3 times less likely to use condoms consistently during the past 3 months, to have used a condom at last intercourse, and to use condoms when intoxicated, nearly 3 times less likely to negotiate condom use, 11 times as likely to have a partner who was physically abusive, nearly 10 times more likely to believe that there were no eligible African American males with whom to establish a relationship, and more than 3 times as likely to believe that sex was unenjoyable. HIV-related social and behavioral interventions for women may be more effective if they address all sexual violence against women, including rape, and provide resources for women who are rape survivors.