Midlife African-American women's protective and risky practices related to HIV

This paper is a report of a study exploring the relationships between social, cultural and individual factors and midlife African-American women's risk taking and protective practices related to HIV/AIDS.

The extent of the HIV epidemic among women of African descent around the world is difficult to discern, but women of color are disproportionately affected. While the risk factors for HIV infection are clearly defined, the context for sexual risk-taking and protective practices is poorly understood for midlife African-American women.

The study was guided by grounded theory methods. The Afrocentric Paradigm, Theory of Gender and Power, and Social Cognitive Theory formed the basis for developing semi-structured interview and focus group schedules. Theoretical sampling and principles of emergent design were used to guide data collection and analysis. Interview and focus group data were collected between 2003 and 2006. Transcripts were analyzed using constant comparison to develop descriptive themes, and member checking was used to verify findings.

African-American women (n = 36) who were between the ages of 40 and 64 years and HIV negative volunteered for the study. Participants characterized their sexual decision-making as two conflicting processes -'Taking Responsibility' and 'Getting Caught Up'- related to being accountable for sexual decision-making and having strong sexual desires.

Stereotypical views of midlife African-American women must be overcome to ensure that they are treated appropriately in the clinical setting. Increasing emphasis on developing woman-controlled HIV prevention approaches holds the greatest hope for controlling the epidemic among women.