High Risk Sex, Syndemic Risk Factors, and Opportunities for Intervention Among Young Adult Multidrug-Using Women of Color

Aim:  This presentation examines HIV risk behavior and related syndemic, health, and social factors among a sample of young adult multi-drug using women of color. 

Method:  Data are drawn from women of color (N=132) completing baseline assessments used in an ongoing behavioral intervention trial. Participants completed either a computer-assisted or audio-assisted personal interview that included well-tested comprehensive measures of substance use, sexual behavior, and related health and social risks.  Eligible participants were ages 18-39, and reported recent (past 90 days) and regular use of club drugs (cocaine, ecstasy, LSD, GHB, ketamine, or methamphetamine) and misuse of prescription medications.  High risk sex was defined as recent unprotected vaginal intercourse (UVI) or unprotected anal intercourse (UAI) in the context of a non-monogamous relationship or with a non-primary partner.

Results:  Mean age was 24.  Women identified as Hispanic (77%), African American/Black (18%), and mixed race/ethnicity (5%).  A majority of women reported recent UVI (91.7%) and UAI (51.5%).  Over 60% (N=80) of women reported either no primary partner or being in a non-monogamous relationship.  Women reporting high risk sex were more likely to report syndemic risks of substance dependence (p=0.039) and lifetime physical and/or sexual victimization (p=0.020), in addition to additional HIV risks of group sex participation (p=0.011) and UVI and/or UAI during group sex (p=0.010), compared to other women.  There were no differences in protective factors of social support or satisfaction with family relationships, friendships, or living situation.  However, compared to women who did not, those reporting high risk sex were less satisfied with goal achievement (p=0.001), coping with or getting help with problems (p=0.007), and how free time is spent (p=0.031). 

Discussion:  Data show that rates of new HIV infection are higher among African American/Black and Hispanic women than among other women and young women account for the majority of these new infections.  Findings from this presentation provide evidence that dissatisfaction in areas of goal achievement, coping, and free time are associated with high risk sex among young adult multidrug-using women of color.  A recent intervention study among MSM, based on theories of empowerment and resilience, has been shown to be efficacious in reducing HIV risk behavior and related syndemic factors, in part by addressing goal setting, fostering positive coping behaviors, and encouraging productive use of free time.  Thus, interventions addressing these areas may be beneficial for vulnerable women of color as well.  Future directions for research and implications for HIV prevention will be discussed.