Perceived HIV risk as a predictor of sexual risk behaviors and discrimination among high-risk women

ABSTRACT

HIV risk perception and discrimination are important determinants of HIV prevention among vulnerable populations. Using Detroit’s 2016 National HIV Behavioral Surveillance (NHBS) Survey, we evaluated demographic variables, risk behaviors, and perception of HIV stigma and discrimination stratified by perceived HIV risk (high, medium, low) in a sample of high-risk women. Significant variables were identified using Pearson Chi-squared tests and one-way analysis of variance tests. Among 541 females surveyed, 93.0% were black and 87.7% lived in poverty. Women’s poverty (p = .010), employment (p = .012), insurance (p = .024) and homelessness status (p < .001) were all significantly associated with their level of HIV risk perception. Among women with low HIV risk perception (76.7%), the majority did not know their partner’s HIV status at last intercourse (68.7%, p = .007), had unprotected anal/vaginal sex in the past year (86.7%, p = .025), participated in sex exchange (63.4%, p < .001), and did not use condoms with a partner with HIV-unknown status (87.2%, p < .001). Half of the women agreed or strongly agreed most people would not be friends with someone with HIV (50.4%), and 46.3% agreed or strongly agreed most people would support PLWH to live or work where they want. Compared to women with low HIV risk perception, women with high perceived HIV risk were more likely to agree or strongly agree most people would discriminate against someone with HIV (87.3% vs. 76.8%) and that people who got HIV via sex exchange or drugs got what they deserve (46.6% vs. 25.8%). Women’s perceived HIV risk was not significantly associated with these discriminatory attitudes. Despite multiple risk behaviors significantly associated with the level of perceived HIV risk in the sample, the NHBS survey demonstrates many women with high-risk behaviors still perceive themselves to be at low risk. Our findings highlight a complex interaction of risk perception, risk behaviors and stigma surrounding HIV in high-risk women.

KEYWORDS:

• High-risk women
• risk behaviors
• HIV
• discrimination

Acknowledgements

The data set associated with this paper is available from the CDC’s National HIV Behavior Surveillance Study 2014–2016 in Detroit, Michigan.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Whitney C. Sewell http://orcid.org/0000-0002-8228-7206

Additional information

Funding

Whitney Sewell has funding support from the Chancellor’s Graduate Fellowship Program at the Washington University in St. Louis, the National Institute on Drug Abuse TranSTAR, and from the Jane B. Aaron National Association of Social Workers Foundation. Stephanie Blankenship has no funding sources to disclose. The above funding sources had no role in the study design, collection/analysis/interpretation of data, or manuscript preparation.