Educated and At-Risk: How the Shortage of Available Partners Influences HIV Risk for College-Educated African-American Women

J Natl Med Assoc. 2018 Jun;110(3):219-230. doi: 10.1016/j.jnma.2017.06.004. Epub 2017 Jul 17.

Abstract

Background: African-Americans have the greatest gender-ratio imbalance compared to other racial groups in the United States. This has been associated with higher rates of concurrent sexual partnerships, increasing risk of HIV infection. College-educated African-American women are of particular interest as they are not often represented in studies on HIV prevention, while their dating and sexual negotiation patterns may differ from those of their lower-educated and lower-income counterparts more often the subject of study in HIV research among African-Americans.

Method: In this qualitative study, we investigate: a) how the gender-ratio imbalance is perceived by college-educated African-American women, b) how they feel limited partner availability impacts heterosexual relationships in the African-American community, and c) the influence this has on their sexual decision making and HIV protective behaviors.

Results: Four major themes emerged- Limited pool of available male partners, Pressure to get married, Feelings of competition among women for male partners, and Men's negotiating power in relationships.

Conclusions: Using the PEN-3 Cultural Model, we discuss how this information may be used to develop interventions for this group of women designed to address their more specific barriers to HIV risk reduction.

Keywords: Black women; HIV/AIDS; Qualitative research; Sexual risk; Social context.

MeSH terms

  • Adult
  • Black or African American* / psychology
  • Black or African American* / statistics & numerical data
  • Female
  • HIV Infections* / epidemiology
  • HIV Infections* / ethnology
  • HIV Infections* / prevention & control
  • Humans
  • Interpersonal Relations
  • Population Dynamics / statistics & numerical data*
  • Qualitative Research
  • Risk Assessment
  • Risk Factors
  • Sexual Behavior / ethnology
  • Sexual Behavior / statistics & numerical data
  • Sexual Partners*
  • United States / epidemiology
  • Universities / statistics & numerical data