Love, sex, and power. Considering women's realities in HIV prevention.

The rates of HIV infection and AIDS cases among women in the United States have increased significantly in the last decade. Thanks in large part to the work of advocacy groups and to action by the U.S. Congress, there has been some progress in making HIV/AIDS research and services more responsive to women's needs (e.g., including women in clinical drug trials and revising the Centers for Disease Control definition of AIDS to include infections typical in women). However, little progress has been made in addressing the need for prevention of HIV infection among women. This article examines how researchers using behavioral approaches to HIV prevention have largely ignored how gender, women's social status, and women's roles affect sexual risk behaviors and the ability to take steps to reduce risk of infection. Additional factors to be considered in theories that guide future HIV/AIDS prevention programs are examined.

[1]  S. Evans,et al.  Women, Sexuality and the Process of Recovery , 1987 .

[2]  P. Freire.  Education for Critical Consciousness , 1973 .

[3]  I. Rosenstock.  The Health Belief Model and Preventive Health Behavior , 1974 .

[4]  V. Adesso,et al.  Psychological Perspectives On Women's Health , 1994 .

[5]  J. Miller,et al.  Toward a new psychology of women , 1976 .

[6]  R. Winett,et al.  Acquired immunodeficiency syndrome/human immunodeficiency virus risk behavior among gay men in small cities. Findings of a 16-city national sample. , 1992, Archives of internal medicine.

[7]  Y. Hser,et al.  Sex differences in addict careers. 1. Initiation of use. , 1987, The American journal of drug and alcohol abuse.

[8]  Thomas J. Coates,et al.  Towards an Understanding of Risk Behavior: An AIDS Risk Reduction Model (ARRM) , 1990, Health education quarterly.

[9]  S. Chu,et al.  Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States. , 1990, JAMA.

[10]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[11]  Blume Sb.  Alcohol problems in women. , 1982 .

[12]  Corinne Squire.  Women and AIDS : psychological perspectives , 1993 .

[13]  J. Kelly,et al.  HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis. , 1991, American journal of public health.

[14]  M. Becker,et al.  The Health Belief Model: Origins and Correlates in Psychological Theory* , 1974 .

[15]  E. Rogers.  Diffusion of Innovations , 1962 .

[16]  A. Kline,et al.  Minority women and sexual choice in the age of AIDS. , 1992, Social science & medicine.

[17]  L. Fitzgerald,et al.  No Safe Haven: Male Violence Against Women at Home, at Work, and in the Community , 1994 .

[18]  M. Chiasson,et al.  Heterosexual transmission of HIV-1 associated with the use of smokable freebase cocaine (crack). , 1991, AIDS.

[19]  E. Perez-stable,et al.  Hispanic Familism and Acculturation: What Changes and What Doesn't? , 1987 .

[20]  L. Ku,et al.  Masculinity Ideology: Its Impact on Adolescent Males' Heterosexual Relationships , 1993 .

[21]  M. R. Fields.  HEALTH EDUCATION MONOGRAPHS , 1960 .

[22]  King K. Holmes,et al.  Research issues in human behavior and sexually transmitted diseases in the AIDS era , 1991 .

[23]  John C. Norcross,et al.  In search of how people change: Applications to addictive behaviors. , 1992 .

[24]  C. Leukefeld,et al.  AIDS and Intravenous Drug Use: Community Intervention & Prevention , 1990 .

[25]  E. Morse,et al.  Barriers to Human Immunodeficiency Virus Related Risk Reduction among Male Street Prostitutes , 1993, Health education quarterly.

[26]  S. Tortu,et al.  The risk of HIV infection in a national sample of women with injection drug-using partners. , 1994, American journal of public health.

[27]  K. Holmes,et al.  The increasing frequency of heterosexually acquired AIDS in the United States, 1983-88. , 1990, American journal of public health.

[28]  A. Barón.  Explorations in Chicano psychology , 1981 .

[29]  M. Handley,et al.  HIV disease and AIDS in women: current knowledge and a research agenda. , 1992, Journal of acquired immune deficiency syndromes.

[30]  R. Valdiserri.  Preventing AIDS : the design of effective programs , 1989 .

[31]  R. Wolitski,et al.  AIDS knowledge, perception of risk, and behaviors among female sex partners of injection drug users. , 1991, AIDS education and prevention : official publication of the International Society for AIDS Education.

[32]  J. Mann.  AIDS: Challenges to Epidemiology in the 1990s , 1991 .

[33]  T. O'Brien,et al.  Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling. , 1993, Journal of acquired immune deficiency syndromes.

[34]  E. Maccoby,et al.  Social Behavior at Thirty-Three Months in Same-Sex and Mixed-Sex Dyads. , 1978 .

[35]  N. Hearst,et al.  Multiple heterosexual partners and condom use among Hispanics and non-Hispanic whites. , 1993, Family planning perspectives.

[36]  N. Jewell,et al.  The effect of number of exposures on the risk of heterosexual HIV transmission. , 1990, The Journal of infectious diseases.

[37]  M. Fullilove,et al.  Black women and aids prevention: A view towards understanding the gender rules , 1990 .

[38]  R. Stephens,et al.  Knowledge about AIDS among intravenous drug users: an evaluation of an education program. , 1991, AIDS education and prevention : official publication of the International Society for AIDS Education.

[39]  J. Kelly,et al.  Community AIDS/HIV risk reduction: the effects of endorsements by popular people in three cities. , 1992, American journal of public health.

[40]  O. Grinstead,et al.  Data from the National AIDS Behavioral Surveys. I. Sexual risk for human immunodeficiency virus infection among women in high-risk cities. , 1993, Family planning perspectives.

[41]  J. Tschann,et al.  Condom use among Hispanic men with secondary female sexual partners. , 1993, Public health reports.

[42]  N. El-Bassel,et al.  Predictors of changes in sexual behavior among women on methadone. , 1993, The American journal of drug and alcohol abuse.

[43]  J. Catania,et al.  Condom use in multi-ethnic neighborhoods of San Francisco: the population-based AMEN (AIDS in Multi-Ethnic Neighborhoods) Study. , 1992, American journal of public health.

[44]  I. Ajzen,et al.  Attitude-behavior relations: A theoretical analysis and review of empirical research. , 1977 .

[45]  M. Guinan,et al.  Epidemiology of AIDS in women in the United States. 1981 through 1986. , 1987, JAMA.

[46]  J. Rodin,et al.  Women and AIDS in the United States: epidemiology, natural history, and mediating mechanisms. , 1992, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[47]  A. Bandura.  Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[48]  Robert Prus,et al.  Women on heroin , 1981 .

[49]  B. Zuckerman,et al.  Drug use among adolescent mothers: profile of risk. , 1989, Pediatrics.

[50]  N. Wallerstein,et al.  Empowerment Education: Freire's Ideas Adapted to Health Education , 1988, Health education quarterly.

[51]  S. Aral,et al.  Women with multiple sexual partners: united states, 1988. , 1992, American journal of public health.

[52]  N. El-Bassel,et al.  15-month followup of women methadone patients taught skills to reduce heterosexual HIV transmission. , 1992, Public health reports.

[53]  Lincoln C. Chen,et al.  AIDS and Women’s Reproductive Health , 2012, Reproductive Biology.

[54]  J. Jemmott,et al.  Increasing condom-use intentions among sexually active black adolescent women. , 1992, Nursing research.

[55]  I. Rosenstock,et al.  Social Learning Theory and the Health Belief Model , 1988, Health education quarterly.

[56]  George W. Albee,et al.  Primary Prevention of AIDS: Psychological Approaches , 1989 .

[57]  S. Kegeles,et al.  Factors Associated With Condom Use in a High‐Risk Heterosexual Population , 1993, Sexually transmitted diseases.

[58]  N. Wallerstein.  Powerlessness, Empowerment, and Health: Implications for Health Promotion Programs , 1992, American journal of health promotion : AJHP.

[59]  J. Prochaska,et al.  Stages and processes of self-change of smoking: toward an integrative model of change. , 1983, Journal of consulting and clinical psychology.

[60]  Y. Hser,et al.  Sex differences in addict careers. 2. Becoming addicted. , 1987, The American journal of drug and alcohol abuse.

[61]  W. Charlesworth,et al.  Gender comparisons of preschoolers' behavior and resource utilization in group problem solving. , 1987, Child development.

[62]  J. Auerbach,et al.  AIDS and behavior : an integrated approach , 1994 .

[63]  H Turner,et al.  Prevalence of AIDS-related risk factors and condom use in the United States. , 1992, Science.

[64]  Z. Stein,et al.  HIV prevention: the need for methods women can use. , 1990, American journal of public health.

[65]  W. Katon,et al.  Medical and psychiatric symptoms in women with childhood sexual abuse. , 1992, Psychosomatic medicine.

[66]  S. Schinke,et al.  Building skills of recovering women drug users to reduce heterosexual AIDS transmission. , 1991, Public health reports.

[67]  S. Hobfoll,et al.  Safer sex knowledge behavior and attitudes of inner-city women. , 1993 .

[68]  B. Zuckerman,et al.  Violence during pregnancy and substance use. , 1990, American journal of public health.

[69]  M. Guinan.  Finding HIV-infected women--the clinician's role. , 1992, Journal of the American Medical Women's Association.

[70]  R. Wolitski,et al.  An experiential program to reduce AIDS risk among female sex partners of injection-drug users. , 1992, Health & social work.

[71]  D. Worth,et al.  Latina women and AIDS. , 1987, SIECUS report.

[72]  S. Kegeles,et al.  Acculturation and gender differences in sexual attitudes and behaviors:Hispanic vs non-Hispanic white unmarried adults. , 1993, American journal of public health.

[73]  J. Collins,et al.  School-based programs to reduce sexual risk behaviors: a review of effectiveness. , 1994, Public health reports.

[74]  J. Watters,et al.  HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack. , 1993, American journal of public health.

[75]  E. Maccoby,et al.  Gender as a social category. , 1988 .