Shamara M Baidoobonso

Sexual health, risk behaviors, and substance use in heterosexual-identified women with female sex partners: 2002 US National Survey of Family Growth.

Background: Despite knowledge that some people engage in same-sex sexuality without espousing a sexual minority identity, this has rarely been studied in women. Methods: Heterosexual women aged 20 to 44 who indicated one or more female sex partners in the past year were compared to those with less recent female sex partners, and to bisexual, homosexual, and exclusively heterosexual women using 2002 US National Survey of Family Growth data. Results: Compared to exclusively heterosexual women, heterosexual women with a past-year female sex partner were significantly more likely to smoke tobacco (46% vs. 19%), binge drink (34% vs. 11%), use marijuana (58% vs. 11%), and use cocaine (19% vs. 2%). Substance use was high in this group overall, but they did not differ significantly from bisexuals on tobacco use or from homosexual or bisexual women on regular alcohol consumption. Most heterosexual women with a past-year female sex partner had only one in their lifetime. They had 10 median lifetime male partners versus 1 to 7 for other groups. Whereas similar to heterosexual women with less recent female sex partners and to bisexual women on some sexual risk measures, these women were more likely than any other group to have had a nonmonogamous male partner (40%) or to have engaged in sex while high (69%). Differences in sexual risk and substance use were not explained by demographic differences. Conclusions: Results suggest same-sex behavior in heterosexual-identified women is a marker for a substance use and sexual risk profile distinct from that of bisexual, lesbian, or exclusively heterosexual women.

HIV risk perception and distribution of HIV risk among African, Caribbean and other Black people in a Canadian city: mixed methods results from the BLACCH study

BackgroundAfrican, Caribbean and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about the epidemiology of HIV risk in this population. This paper helps fill the knowledge gap by: presenting service providers’ and ACB people’s perceptions about HIV risk in ACB populations; describing the distribution of HIV risk behaviours among ACB people according to markers of social status and position; and comparing results from these two analyses.MethodsThe Black, African and Caribbean Canadian Health (BLACCH) Study is a mixed methods study that used semi-structured interviews and a cross-sectional quantitative questionnaire to collect information about HIV and health from 188 ACB people in London, Ontario, Canada. Qualitative content analysis was used to identify interview themes, and weighted bivariate statistical analyses were performed on the quantitative data. Behaviours related to HIV risk were stratified by sex, poverty status, immigration experience and employment status.ResultsCommunity members perceived that they were at low risk for HIV and mainly focused on sexual risks. They called for more information about HIV in Canada and culturally appropriate HIV services. Service providers cited marital infidelity and cultural and religious attitudes about condoms as barriers to women protecting themselves. They mentioned cultural norms, beliefs about masculinity and underrepresentation of heterosexual ACB men at AIDS service organizations as barriers to men protecting themselves. There were few statistically significant differences in risk behaviours reported by men and women. Those living in poverty were more likely to abstain from sex (p = 0.006) and use condoms (p = 0.027) in the past year. Those living in Canada longer reported higher prevalences of forced sex (p < 0.001), mixing alcohol or drugs with sex (p = 0.001) and past STI diagnoses (p = 0.032). Stable employment was associated with higher prevalences of not using condoms in the past year (p = 0.005) and past STI diagnoses (p = 0.018).ConclusionsThe results show that perceptions about ACB people’s HIV risk differ from actual risk, and those with higher social standing might be at greater risk. Furthermore, the social determinants of health are important factors in the epidemiology of HIV among ACB people.