Predicting Condom Use among Latina Women Using the Social-Ecological Model Público

Abstract

Introduction: Latinos are disproportionately affected by HIV compared to other racial and ethnic groups, accounting for approximately 20% of all HIV prevalence in the United States. In 2005, HIV/AIDS was the fourth leading cause of death among Latina women aged 35-44 and nearly half of Latina adults and adolescents contract HIV/AIDs through high-risk heterosexual contact.

Objective: The aim of this study was to assess the relationship between condom use behaviors and health insurance status, gender role views, power in the relationship, condom attitudes, time living in the United States, country of birth, and legal immigration status among Latina women, within the constructs of the Social-Ecological Model.

Methods: This study utilized a cross-sectional design and secondary, quantitative data analysis of the AMIGAS (Amigas, Mujeres Latinas, Inform Andonos, Gui andonos, y Apoy andonos contra el SIDA [friends, Latina women, informing each other, guiding each other, and supporting each other against AIDS]) dataset. Convenience sampling was used to survey 251 Latina women aged 18 to 35 in the Miami metropolitan area from October 2008 to October 2009.

Results: Increased condom use was found to be significantly associated with lower age and having a paid job, health insurance, fewer traditional views of gender roles, more positive condom attitudes, and later age at immigration. However, both birth in a Caribbean country and greater time living in the U.S. was significantly associated with reduced condom use. There was no association found between power in the relationship and condom use.

Conclusion: These findings highlight the continual need for culturally sensitive HIV prevention programs for Latina women. Further research is needed to explore the relationship between health insurance and condom use, how cultural barriers to safer sex practices may differ by country of origin, and how living in a predominantly Latino community may influence the degree of acculturation and social norms around sexual health behaviors.

Table of Contents

TABLE OF CONTENTS

INTRODUCTION..........................................................................................................1

Background and Significance........................................................................................1

Study Rationale.........................................................................................................1

Theoretical Framework................................................................................................2

LITERATURE REVIEW.................................................................................................. 5

History and Overview of the Hispanic/Latino Population in Miami, Florida ..............................5

HIV among Immigrants................................................................................................6

HIV Risk Factors and the Social-Ecological Model.............................................................7

Summary.................................................................................................................15

METHODS.................................................................................................................17

Design.....................................................................................................................17

Participants..............................................................................................................17

Procedures...............................................................................................................18

Measures..................................................................................................................18

Data Analysis Plan.......................................................................................................23

RESULTS...................................................................................................................24

Sample Characteristics................................................................................................24

Bivariate Analysis........................................................................................................25

Linear Regressions.......................................................................................................27

Logistic Regressions.....................................................................................................33

DISCUSSION................................................................................................................39

Findings by Theory.......................................................................................................39

Strengths and Limitations..............................................................................................44

Implications and Recommendations for Research and Practice...............................................45

REFERENCES.................................................................................................................47

TABLES

Table 1. Characteristics of Sample..............................................................................................25

Table 2. Bivariate Analysis..........................................................................................................26-27

Table 3. Linear Regression Analysis of Percent Condom Use during Vaginal Sex in the Past 90 Days..........28

Table 4. Linear Regression Analysis of Percent Condom Use during Vaginal Sex in the Past 30 Days..........29

Table 5. Linear Regression Analysis of Percent Condom Use during Anal Sex in the Past 90 Days...............31

Table 6. Linear Regression Analysis of Percent Condom Use during Anal Sex in the Past 30 Days..............33

Table 7. Logistic Regression Analysis of Consistent Condom Use during Vaginal Sex in the Past 90 Days.....34

Table 8. Logistic Regression Analysis of Consistent Condom Use during Vaginal Sex in the Past 30 Days.....35

Table 9. Logistic Regression Analysis of Never Using Condoms in the Past 90 Days.................................36

Table 10. Logistic Regression Analysis of Never Using Condoms in the Past 30 Days................................37

FIGURES

Figure 1: Social Ecological Model...................................................................................................3

APPENDICES

Appendix A: IRB Letter of Determination..........................................................................................53

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	HIV Women Social-Ecological country of origin health insurance AIDS Hispanic Condom Use Latina Socio-Ecological
Committee Chair / Thesis Advisor	Lang, Delia L, Emory University
Committee Members	Wingood, Gina M, Emory University Sales, Jessica, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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