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Employment, Social Support, and HIV Sexual-Risk Behavior in Puerto Rican Women

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Abstract

This study examined psychosocial factors associated with HIV-risk behavior among Latina women at self-disclosed heterosexual risk for HIV infection. Data were collected via structured interviews for 187 Puerto Rican women, aged 18–35, who attended a health clinic in the Bronx, New York. Over 64% of all participants reported unprotected vaginal sex with primary sexual partners. Higher levels of unprotected vaginal sex were associated with living with the partner, residing with children, current employment, heightened negative mood, and greater social support from the partner. The relationship between increased negative mood and increased unprotected vaginal sex use was mediated by employment, after controlling for educational level, living with the partner, and residing with children. The findings suggest that interventions designed to facilitate HIV-protective behaviors may need to consider that employment may supercede relationship factors among populations of urban women identified at increased heterosexual risk for HIV infection.

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REFERENCES

  • Amaro, H. (1988). Considerations for prevention of HIV infection among Hispanic women. Psychology ofWomen Quarterly, 12, 429–443.

    Google Scholar 

  • Amaro, H. (1995). Love, sex, and power: Considering women's realities in HIV prevention. American Psychologist, 50, 437–447.

    Google Scholar 

  • Anderson, N. B. (1995). Behavioral and sociocultural perspectives on ethnicity and health: Introduction to the special issue. Health Psychology, 14, 589–591.

    Google Scholar 

  • Anderson, R. M., and May, R. M. (1988). Epidemiological parameters of HIV transmission. Nature, 333, 514–522.

    Google Scholar 

  • Anson, O., and Anson, J. (1987). Women's health and labour force status: An enquiry using a multi-point measure of labour force participation. Social Science and Medicine, 25, 57–63.

    Google Scholar 

  • Antoni, M. H., and Schneiderman, N. (1998). HIV and AIDS. In A. S. Bellack and M. Hersen (Eds.), Comprehensive clinical psychology (pp. 238-275). New York: Pergamon.

    Google Scholar 

  • Antoni, M. H., Goodkin, K., Goldstein, V., LaPerriere, A., Ironson, G., Fletcher, M., and Schneiderman, N. (1990). Coping responses to HIV-1 serostatus notification predict shortterm affective distress and one-year immunologic status in HIV-1 seronegative and seropositive gay men. Psychosomatic Medicine, 53, 227.

    Google Scholar 

  • Arber, S. (1991). Class, paid employment and family roles: Making sense of structural disadvantage, gender and health status. Social Science and Medicine, 32, 425–436.

    Google Scholar 

  • Ballantyne, P. J. (1999). The social determinants of health: A contribution to the gender differences in health and illness. Scandinavian Journal of Public Health, 27, 290–295.

    Google Scholar 

  • Broadhead, W. E., Kaplan, B., James, S., Wagner, E., Schoenbach, U., Grimson, R., Heyden, S., Tibblin, G., and Gehlbach, S. (1983). The epidemiologic evidence for a relationship between social support and health. American Journal of Epidemiology, 117, 521–537.

    Google Scholar 

  • Brown, E. J. (1998). Female injecting drug users: Human immunodeficiency virus risk behavior and intervention needs. Journal of Professional Nursing, 14, 361–369.

    Google Scholar 

  • Carballo-Dieguez, A., and Dolezal, C. (1996). HIV risk behaviors and obstacles to condom use among Puerto Rican men in New York City who have sex with men. American Journal of Public Health, 86, 1619–1622.

    Google Scholar 

  • Carmona-Vargas, J., Romero, G. J., and Loeb, R. B. (1999). The impact of HIV status and acculturation on Latinas' sexual risk taking. Cultural Diversity and Ethnic Minority Psychology, 5, 209–221.

    Google Scholar 

  • Centers for Disease Control and Prevention, Department of Health and Human Services, National Center for HIV, STD and TB Prevention. (1999). HIV/AIDS Surveillance Report, U.S. HIV and AIDS cases reported through June 1999, 11. Atlanta, Georgia.

  • Choi, K. H., Catania </del>, J. A., and Dolcini, M. M. (1994). Extramarital sex and HIV risk behavior among US adults: Results from the national AIDS behavioral study. American Journal of Public Health, 84, 2003–2007.

    Google Scholar 

  • Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7, 269–297.

    Google Scholar 

  • Cohen, S., and Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13, 99–125.

    Google Scholar 

  • Cohen, S., and McKay, G. (1984). Social support, stress, and the buffering hypothesis: A theoretical analysis. In A. Baum, S. E. Taylor, and J. E. Singer (Eds.), Handbook of psychology and health (Vol. 4, pp. 253-267). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Cohen, S., and Syme, S. (Eds.). (1985). Social support and health. New York: Academic press.

    Google Scholar 

  • Cohen, S., and Wills, T. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.

    Google Scholar 

  • Conant, M., Hardy, D., Sernatinger, J., Spicer, D., and Levy, J. A. (1986). Condoms prevent transmission of AIDS-associated retrovirus. Journal of the American Medical Association, 255, 1706.

    Google Scholar 

  • Cruess, S., Antoni, M. H., Kilbourn, K., Ironson, G., Klimas, N., Fletcher, M. A., Baum, A., and Schneiderman, N. (2000). Optimism, distress and immunologic status in HIV-infected gay men following Hurricane Andrew. International Journal of Behavioral Medicine, 7, 160–182.

    Google Scholar 

  • Cutrona, C. E. (1989). Ratings of social support by adolescents and adult informants: Degree of correspondence and prediction of depressive symptoms. Journal of Personality and Social Psychology, 57, 723–730.

    Google Scholar 

  • Deren, S., Sanchez, J., Shedlin, M., Davis, W. R., Beardsley, M., Des Jarlais, D., and Miller, K. (1996). HIV risk behaviors among Dominican brothel and street prostitutes in New York City. AIDS Education and Prevention, 8, 444–456.

    Google Scholar 

  • Diaz, T., Chu, S. Y., Conti, L., Sorvillo, F., Caeca, P. J., and Hermann, P. (1994). Risk behaviors of persons with heterosexually acquired HIV infection in the United States: Results of a multistate surveillance project. Journal of Acquired Immune Deficiency Syndromes, 7, 958–963.

    Google Scholar 

  • Dilly, J. W., McFarland, W., Sullivan, P., and Discepola, M. (1998). Psychosocial correlates of unprotected anal sex in a cohort of gay men attending an HIV-negative support group. AIDS Education and Prevention, 10, 317–326.

    Google Scholar 

  • Dixon,D., Antoni, M., Kilbourn, K., Wagner, S., Schneiderman,N., Klimas, N., and Fletcher, M. A. (1998). Social support buffers PTSD symptoms and HHV-6 antibody tiers in HIVC gay men following Hurricane Andrew. NeuroImmunoModulation, 5, 15.

    Google Scholar 

  • Dixon,D., Antoni, M., Wagner, S., Kilbourn, K., Schneiderman,N., Klimas,N., and Fletcher, M. A. (1999). Acute and sustained effects of anxiety on immune status and social support in HIVC gay men following Hurricane Andrew. NeuroImmunoModulation, 6, 214.

    Google Scholar 

  • Dixon, D. A., Cruess, S., Kilbourn, K., Klimas, N., Fletcher, M. A., Ironson, G., Baum A., Schneiderman, N., and Antoni, M. (2001). Social support mediates the relationship between loneliness and Human Herpsesvirus-6 antibody titers in HIVCgay men following Hurricane Andrew. Journal of Applied Social Psychology, 31(6), 1111–1132.

    Google Scholar 

  • Dolcini, M. M., Coates, T. J., Catania, J. A., Kegeles, S. M., and Hauck, W. W. (1995). Multiple sexual partners and their psychosocial correlates: The population-based AIDS in multiethnic neighborhoods (AMEN) study. Health Psychology, 14, 22–31.

    Google Scholar 

  • el-Bassel, N., and Schilling, R. F. (1994). Social support and sexual risk taking amongwomenon methadone. AIDS Education and Prevention, 6, 506–513.

    Google Scholar 

  • Elliott, B. J., and Huppert, F. A. (1991). In sickness and in health: Associations between physical and mental well-being, employment and parental status in a British nationwide sample of married women. Psychological Medicine, 21, 515–524.

    Google Scholar 

  • Eversley, R. B., Newstetter, A., Avins, A., Beirnes, D., Haynes-Sanstad, K., and Hearst, N. (1993). Sexual risk and perception of risk for HIV infection among multiethnic family planning clients. American Journal of Preventive Medicine, 9, 92–95.

    Google Scholar 

  • Flack, J. M., Amaro, H., Jenkins, W., Kunitz, S., Levy, J., Mixon, M., and Yu, E. (1995). Behavioral and sociocultural perspectives on ethnicity and health: Panel I: Epidemiology of minority health. Health Psychology, 14, 592–600.

    Google Scholar 

  • Folkman, S., Chesney, M. A., Pollack, L., and Phillips, C. (1992). Stress, coping, and high-risk sexual behavior. Health Psychology, 11, 218–222.

    Google Scholar 

  • Francis, D. P., and Chin, J. (1987). The prevention of acquired immunodeficiency syndrome in the United States: An objective strategy for medicine, public health, business, and the community. Journal of the American Medical Association, 257, 1357–1366.

    Google Scholar 

  • Friedland, G. H., and Klein, R. S. (1987). Transmission of the human immunodeficiency virus. New England Journal of Medicine, 317, 1125–1135.

    Google Scholar 

  • Galavotti, C., Cabral, R. J., Lansky, A., Grimley, D. M., Riley, G. E., and Prochaska, J. O. (1995). Validation of measures of condom and other contraceptive use among women at high risk for HIV infection and unintended pregnancy. Health Psychology, 14, 570–578.

    Google Scholar 

  • Gielen, A. C., Faden, R. R., O'Campo, P., Kass, N., and Anderson, J. (1994). Women's protective sexual-behaviors: A test of the health belief model. AIDS Education and Prevention, 6, 1–11.

    Google Scholar 

  • Gomez, C. A., Hernandez, M., and Faigeles, B. (1999). Sex in the New World: An empowerment model of HIV prevention in Latina immigrant women. Health, Education and Behavior, 26, 200–212.

    Google Scholar 

  • Grella, C. E., Annon, J. J., and Anglin, M. D. (1995). Ethnic differences in HIV risk behaviors, self-perceptions, and treatment outcomes among women in methadone maintenance treatment. Journal of Psychoactive Drugs, 27, 421–433.

    Google Scholar 

  • Gwinn, M., Pappaioanou, M., Geeorge, J., Hannon, W., Wasser, S., Redus, M., Hoff, R., Grady, G., Willoughby, A., Novello, A., Peterson, L., Dondero, T., and Curran, J. (1991). Prevalence of HIV infection in childbearing women in the United States. Journal of the American Medical Association, i265, 1704–1708.

    Google Scholar 

  • Harlow, L. L., Rose, J. S., Morokoff, P. J., Quina, K., Mayer, K., Mitchell, K., and Schnoll, R. (1998). Women HIV sexual risk takers: Related behaviors, interpersonal issues, and attitudes. Womens Health, 4, 407–439.

    Google Scholar 

  • Harrison, J., S., Norris, F. H., Kay, K. L., Dixon, D., Peters, M., and Moore, J. (1996). Heterosexual risk for HIV among Puerto Rican women: Does power influence self-protective behavior? Paper presented at the Eleventh International Conference on AIDS, Vancouver, British Columbia, Canada.

  • Harrison, D. F., Wambach, K. G., Byers, J. B., Imershein, A. W., Levine, P., and Maddox, K. (1991). AIDS knowledge and risk behaviors among culturally diverse women. AIDS Education and Prevention, 3, 79–89.

    Google Scholar 

  • Hays, R. B., Chauncey, S., and Tobey, L. (1990). The social support networks of gay men with AIDS. Journal of Community Psychology, 18, 374–385.

    Google Scholar 

  • Hays, R. B., Turner, H., and Coates, T. J. (1992). Social support, AIDS-related symptoms, and depression among gay men. Journal of Consulting and Clinical Psychology, 60, 463–469.

    Google Scholar 

  • Hibbard, J. H., and Pope, C. R. (1985). Employment status, employment characteristics and women's health. Women and Health, 10, 59–77.

    Google Scholar 

  • Johnson, K. W., Anderson, N. B., Bastida, E., Kramer, B. J., Williams, D., and Wong, M. (1995). Behavioral and sociocultural perspectives on ethnicity and health: Panel II: Macrosocial and environmental influences on minority health. Health Psychology, 14, 601–612.

    Google Scholar 

  • Kalichman, S. C., and Stevenson, L.Y. (1997). Psychological and social factors associated with history of risk for human immunodeficiency virus infection among African-American inner-city women. Journal of Women's Health, 6, 209–217.

    Google Scholar 

  • Kelly, J. A., Murphy, D. A., Bahr, G. R., Koob, J. J., Morgan, M. G., Kalichman, S. C., Stevenson, L. Y., Brasfield, T. L., Bernstein, B. M., and St. Lawrence, J. S. (1993). Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection. Health Psychology, 12, 215–219.

    Google Scholar 

  • Kelly, J. A., Sikkema, K. J., Winett, R. A., Solomon, L. J., Roffman, R. A., Heckman, T. G., Stevenson, L. Y., Perry, M. J., Norman, A. D., and Desiderato, L. J. (1995). Factors predicting continued high-risk behavior among gay men in small cities: Psychological, behavioral, and demographic characteristics related to unsafe sex. Journal of Consulting and Clinical Psychology, 63, 101–107.

    Google Scholar 

  • LaCroix, A. Z., and Haynes, S. G. (1987). Gender differences in the health effects of workplace roles. In R. C. Barnett, L. Biener, and G. K. Baruch (Eds.), Gender and stress (pp. 96-117). New York: The Free Press.

    Google Scholar 

  • Leserman, J., Jackson, E., Petitto, J., Golden, R., Silva, S., Perkins, D., Cai, J., Folds, J., and Evans, D. L. (1999). Progression to AIDS: The effects of stress, depressive symptoms, and social support. Psychosomatic Medicine, 61, 397–406.

    Google Scholar 

  • Lutgendorf, S., Antoni, M., Ironson, G., Starr, K., Costello, N., Zuckerman, M., Klimas, N., Fletcher, M. A., and Schneiderman, N. (1998). Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-seropositive gay men. Psychosomatic Medicine, 60, 204–214.

    Google Scholar 

  • Marin, B. V., Gomez, C. A., and Hearst, N. (1993a). Multiple heterosexual partners and condom use among Hispanics and non-Hispanic Whites. Family Planning Perspectives, 25, 170–174.

    Google Scholar 

  • Marin, B. V., Tschann, J. M., Gomez, C. A., and Kegeles, S. M. (1993b). Acculturation and gender differences in sexual attitudes and behaviors: Hispanic vs Non-Hispanic White unmarried adults. American Journal of Public Health, 83, 1759–1761.

    Google Scholar 

  • Mayne, T. J., Acree, M., Chesney, M. A., and Folkman, S. (1998). HIV sexual risk behavior following bereavement in gay men. Health Psychology, 17, 403–411.

    Google Scholar 

  • McCoy, H. V., and Inciardi, J. A. (1993). Women and AIDS: Social determinants of sex-related activities. Women and Health, 20, 69–86.

    Google Scholar 

  • McNair, D. H., Lorr, M., and Droppelman, L. F. (1992). Manual for the profile of mood states. Revised 1992. San Diego, CA: Edits Education and Industrial Testing Service.

    Google Scholar 

  • Miller, M. (1999). A model to explain the relationship between sexual abuse and HIV risk among women. AIDS Care, 11, 3–20.

    Google Scholar 

  • Miller, G. E., Kemeny, M., Taylor, S., Cole, S., and Vissher, B. (1997). Social relationships andimmuneprocesses inHIVseropositive gay and bisexual men. Annals of Behavioral Medicine, 19, 139–151.

    Google Scholar 

  • Moore, J., Harrison, J. S., Kay, K. L., Deren, S., and Doll, L. S. (1995). Factors associated with Hispanic women's HIV-related communication and condom use with male partners. AIDS Care, 7, 415–427.

    Google Scholar 

  • Morrill, A. C., Ickovis, J. R., Golubchikov, V. V., Beren, S. E., and Rodin, J. (1996). Safer sex: Social and psychological predictors of behavioral maintenance and change among heterosexual women. Journal of Consulting and Clinical Psychology, 64, 819–828.

    Google Scholar 

  • Namir, S., Alumbaugh, M., Fawzy, F., and Wolcott, D. (1989). The relationship of social support to physical and psychological aspects of AIDS. Psychology and Health, 3, 77–86.

    Google Scholar 

  • Neal, J. J., Fleming, P. L., Green, T. A., and Ward, J. W. (1997). Trends in heterosexually acquired AIDS in the United States, 1988 through 1995. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 14, 465–474.

    Google Scholar 

  • Newcomb, M. D., Wyatt, G. E., Romero, G. J., Tucker, M. B., Wayment, H. A., Carmona, J. V., Solis, B., and Mitchell-Kernan, C. (1998). Acculturation, sexual risk-taking, and HIV health promotion among Latinas. Journal of Counseling Psychology, 45, 454–467.

    Google Scholar 

  • Nyamathi, A. (1992). Comparative study of factors relating to HIV risk level of black homeless women. Journal of Acquired Immune Deficiency Syndrome, 5, 222–228.

    Google Scholar 

  • Orr, S. T., Celentano, D. D., Santelli, J., and Burwell, L. (1994). Depressive symptoms and risk factors for HIV acquisition among black women attending urban health centers in Baltimore. AIDS Education and Prevention, 6, 230–236.

    Google Scholar 

  • Paone, D., Cooper, H., Alperen, J., Shi, Q., and DesJarlais, D. C. (1999). HIV risk behaviours of current sex workers attending syringe exchange: The experiences of women in five US cities. AIDS Care, 11, 269–280.

    Google Scholar 

  • Penninx, B. W. J. H., van Tilburg, T., Boeke, A., Deeg, D., Kriegsman, K., and van Eijk, J. (1998). Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases? Health Psychology, 17, 551–558.

    Google Scholar 

  • Potter, L. B., and Anderson, J. E. (1993). Patterns of condom use and sexual behavior among never-married women. Sexually Transmitted Diseases, 20, 201–208.

    Google Scholar 

  • Reviere, R., and Eberstein, I. W. (1992). Work, marital status, and heart disease. Health Care for Women International, 13, 393–399.

    Google Scholar 

  • Robbins, A. G., Dew, M. A., Davidson, S., Pendower, L., Becker, J. T., and Kingsley, L. (1994). Psychosocial factors associated with risky sexual behavior among HIV-seropositive gay men. AIDS Education and Prevention, 6, 483–492.

    Google Scholar 

  • Romero, G. J., and Arguellas, L. (1993). AIDS knowledge and beliefs of citizen and non-citizen Chicanas/Mexicanas. Latino Studies Journal, 4, 79–94.

    Google Scholar 

  • Rosenfeld, J. A. (1992). Maternal work outside the home and its effect on women and their families. Journal of the American Medical Women's Association, 47, 47–53.

    Google Scholar 

  • Rotheram-Borus, M. J., Rosario, M., Reid, H., and Koopman, C. (1995). Predicting patterns of sexual acts among homosexual and bisexual youths. American Journal of Psychiatry, 152, 588–95.

    Google Scholar 

  • Sabogal, F., Faigeles, B., and Catania, J. A. (1993). Data from the National AIDS Behavioral Surveys: II. Multiple sexual partners among Hispanics in high-risk cities. Family Planning Perspectives, 25, 257–262.

    Google Scholar 

  • Skurnick, J. H., Abrams, J., Kennedy, C. A., Valentine, S. N., and Cordell, J. R. (1998). Maintenance of safe sex behavior by HIV-serodiscordant heterosexual couples. AIDS Education and Prevention, 10, 493–505.

    Google Scholar 

  • Sikkima, E. J., Heckman, T.G., Kelly, J. A., Anderson, E. S., Winett, R. A., Solomon, L. J., Wagstaff, D. A., Roffman, R. A., Perry, M. J., Cargill, V., Crumble, D. A., Fuqua, R. W., Norman, A. D., and Mercer, M. B. (1996). HIV risk behaviors among women living in low income, inner city housing developments. American Journal of Public Health, 86, 1123–1128.

    Google Scholar 

  • Somlai, A. M., Kelly, J. A., Wagstaff, D. A., and Whitson, D. P. (1998). Patterns, predictors, and situational contexts of HIV risk behaviors of among homeless men and women. Social Work, 43, 7–20.

    Google Scholar 

  • Strathdee, S. A., Hogg, R. S., Martindale, S. L., Cornelisse, P. G., Craib, K. J., Montaner, J. S., O'Shaughnessy, M. V., and Schechter, M. T. (1998). Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, 19, 61–66.

    Google Scholar 

  • Turner, H. A., Hays, R., and Coates, T. (1993). Determinants of social support among gay men: The context of AIDS. Journal of Health and Social Behavior, 34, 37–53.

    Google Scholar 

  • Wheeler, A. P., Lee, E. S., and Loe, H. D. (1983). Employment, sense of well-being, and use of professional services among women. American Journal of Public Health, 73, 908–911.

    Google Scholar 

  • Wilson T. E., Jaccard, J., Levinson, R. A., Minkoff, H., and Endias, R. (1996).Testing forHIVand other sexually transmitted diseases: Implications for risk behavior in women. Health Psychology, 15, 252–260.

    Google Scholar 

  • Woodhouse, D. E., Rothenberg, R.B., Potterat, J. J., Darrow, W. W., Muth, S. Q., Klovdahl, A. S., Zimmerman, H. P., Rogers, H. L., Maldonado, T. S., and Muth, J. B. (1994). Mapping of social network of heterosexuals at high risk for HIV infection. AIDS, 8, 1331–1336.

    Google Scholar 

  • Wortman, C. B. (1984). Social support and the cancer patient: Conceptual and methodologic issues. Cancer, 53, 2339–2362.

    Google Scholar 

  • Wyatt, G. E. (1992). The sociocultural context of African American and European American women's rape. Journal of Social Issues, 48, 77–91.

    Google Scholar 

  • Wyatt, G. E. (1994). The sociocultural relevance of sex research: Challenges for the 1990s and beyond. American Psychologist, 49, 748–754.

    Google Scholar 

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  1. Department of Epidemiology and Social Medicine, Division of Health and Behavior, Albert Einstein College of Medicine, Bronx, New York

    Denise A. Dixon & Michael Peters

  2. Department of Psychology, University of Miami Behavioral Medicine Research Center, Miami, Florida

    Michael Antoni

  3. Centers for Disease Control and Prevention, Atlanta, Georgia

    Janet Saul

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  1. Denise A. Dixon
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Dixon, D.A., Antoni, M., Peters, M. et al. Employment, Social Support, and HIV Sexual-Risk Behavior in Puerto Rican Women. AIDS Behav 5, 331–342 (2001). https://doi.org/10.1023/A:1013134822868

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