Studies have not yet explored the influence of all of these factors on self-efficacy for HIV prevention among Hispanic women. Consistent with the literature, we hypothesized that predictors of self-efficacy for HIV prevention described in the literature would influence self-efficacy for HIV prevention among Hispanic women. Younger women have higher levels of self-efficacy for HIV prevention.
In comparison to older women, younger women tend to more consistently use prevention behaviors. Younger women are more likely to use condoms. They also communicate and negotiate more with their sexual partners Lauby et al. Women who live with a partner have lower self-efficacy for HIV prevention. Perhaps this is due to being in a stable relationship. Women in these relationships may not consider HIV as a point of concern and, thus, do not engage in HIV prevention behavior Lauby et al.
Unemployed women and those living in poverty had lower self-efficacy for HIV prevention. Additionally, women with limited economic resources and those who were completely dependent on their main sexual partners reported lower self-efficacy for HIV prevention. These women tended to prioritize their daily survival over long-term concerns like HIV prevention Lauby et al.
An individual with HIV knowledge has specific information about the transmission, prevention, and consequences of HIV infection Bandura, Studies have reported that higher levels of HIV knowledge were positively associated with self-efficacy for HIV prevention Villegas et al. Women who have lower self-esteem often feel discouraged and vulnerable and are unable to adequately perform daily activities. Self-efficacy is a critical element for HIV prevention Bandura, ; Bandura, ; however, little is known about the predictors of self-efficacy for HIV prevention among Hispanic women.
The purpose of this study was to assess if factors such as age, living with a partner, employment status, HIV-related knowledge, self-esteem, and IPV, were predictive factors for self-efficacy for HIV prevention among Hispanic women in Florida. A sample of Latina women from South Florida was selected. To participate in the study the women had to a self-identify as Hispanic women, b fall within the age group of 18 to 50 years, and c have been sexually active in the previous 3 months of initial eligibility screening.
The researchers posted flyers and made presentations at a community-based organization CBO that provided social services e. The researchers also used other community-based settings e.
Additionally, the women in the study were encouraged to tell their families and friends e. The researchers initially conducted assessments at the aforementioned CBO. When study enrollment increased and the demands of the study began to strain the resources of the CBO, the researchers secured a nearby office to continue assessments.
Personnel for the study were bilingual females who researchers trained to follow a standardized research protocol. For these measures, participants selected their language of preference, English or Spanish. Candidates interested in participating in SEPA provided study personnel with their names and phone numbers. A centralized scheduler contacted the candidates to screen for eligibility. Baseline assessments took approximately 3 hours to complete.
Participants received a monetary incentive upon completion of the assessment to compensate for time, travel, and child care costs. We used a standardized demographic form created for all studies undertaken at the research center. Study personnel collected demographic information at the beginning of the assessments Peragallo et al. A higher score indicated a higher level of HIV-related knowledge.
This measure has been previously used in a population of Hispanic women in the United States Peragallo et al. The modified version of the Conflict Tactics Scales had 12 items to detect the presence of four specific types of IPV: physical, psychological, economic, and sexual.
Women who reported the presence of violence in at least one of the items, received one point in the dummy coding. This modified scale has been used in a Hispanic population in the United States Peragallo et al.
Scores ranged from 10—40 points, with a higher score indicating more self-esteem. The measure has been used in the Hispanic population in the United States and in a Chilean population Peragallo et al. The seven self-assessement items were previously used in a Hispanic population in the United States Peragallo et al. We used PASW version The simultaneous standard multiple regression analysis described the relationship between the outcome variable self-efficacy for HIV prevention and a set of independent variables or predictors.
The independent continuous variables were age, HIV-related knowledge, and self-esteem. The independent dichotomous variables were living with a partner, employment status, and IPV. The descriptive statistics supported the use of multiple regression analyses.
The variables included in the model met the assumptions for the test and required no transformations. In addition, statistical tests for collinearity assessed the quality of the linear relationships among the predictor variables. Both tolerance and variance inflation factor analysis were conducted; the analyses demonstrated no multi-collinerarity among the predictors as tolerance ranged from. The demographic characteristics of the participants are presented in Table 1.
One third of the women reported being employed. Almost half indicated that they were married. More than two thirds of the participants lived with a spouse or partner. More than half of the women identified their religion as Catholic. The vast majority almost two thirds did not have health insurance coverage. A majority of the participants were born outside of the United States in Colombia Items that scored the lowest percentage of correct answers were: Most of the people who carry the AIDS virus look and feel healthy The items that the majority of the women answered correctly were those that dismissed the ideas that: birth control pills protect against the AIDS virus The majority of the women Furthermore, 9.
The mean score for self-esteem among the participants was Items such as I wish I could have more respect for myself The mean score for self-efficacy for HIV prevention was More than half of the participants scored 23 points or higher on this scale; the majority of the women reported high levels of self-efficacy for HIV prevention. We used a simultaneous linear multiple regression analysis with six predictor variables to determine the correlates of self-efficacy for HIV prevention Table 2.
The six predictors entered simultaneously into the model included age, living with the partner, employment status, HIV knowledge, IPV, and self-esteem. After excluding 27 cases due to missing data, a total of completed cases were used for the analysis. The six explanatory variables together accounted for Age had a small but meaningful effect on self-efficacy for HIV prevention and explained 0.
Employment status explained 0. This means that SEPA can be adapted for women who are not Hispanic or Latino if they are in need of information on HIV and STD prevention and domestic violence and if they need to strengthen their skills in communication with male partners, condom use, and condom negotiation.
SEPA consists of six two-hour sessions that include presentations, group discussions, and practice exercises on male and female condom use, condom negotiation, and assertive communication. Session content covers HIV and STD transmission and prevention, male and female reproductive anatomy, human sexuality, interpersonal communications, and domestic and intimate partner violence.
Research Results SEPA produced significant outcomes among low-income Mexican and Puerto Rican women between the ages of 18 and 44 in Chicago where the intervention was tested between and Compared to members of the control group, SEPA participants showed significant increases in:.
In addition, SEPA participants had significant decreases in perceived barriers to condom use. A randomized clinical trial of an HIV-risk reduction intervention among low income Latina women. Nursing Research, 54 2 , SEPA is one of the REP interventions and is the product of extensive collaboration among researchers, community based advisors, and health promotion experts.
For example, media campaigns designed to increase HIV-related knowledge, encourage routine HIV testing, and promote condom use have been found to be beneficial in reducing HIV risk behaviors and promoting healthy behaviors. These challenges can be addressed by taking into consideration the unique life experiences of African American women.
Prevention science has not sufficiently addressed the ontogenetic problems of childhood sexual abuse, PTSD, and substance abuse among African American women. Specific prevention strategies should include psychoeducation and skills-building activities to allow these women to cope with the consequences of trauma and substance abuse.
Combining single-gender groups and couple sessions with both the woman and her partner may be an effective prevention strategy to increase sexual decision-making power and to enable African American women to negotiate sexual and drug risk reduction with their male partners. Such hybrid approaches may effectively target the full range of individual and interpersonal risk factors and reduce the gender role power imbalances associated with HIV risk reduction among African American women and their sexual partners.
Exosystem risk factors such as poverty, unemployment, lack of access to health care, stigma, and lack of culturally congruent prevention approaches in health care systems are all serious challenges to expanding access to effective HIV prevention among African American women.
Continued efforts toward improving the socioeconomic status of African American women and increasing their access to culturally congruent prevention strategies are needed. Finally, macrosystem factors such as cultural beliefs, social norms, gender roles, and power imbalances among African American women need to be addressed.
HIV prevention strategies may include media campaigns and community-based programs that involve social networks and local organizations. Moreover, policy-based interventions geared toward increasing funding for HIV prevention programs in the African American community and protecting and improving African American women's rights in the United States are essential.
We endorse the notion that risk factors overlap and interact with each other and that one prevention strategy or type does not fit all African American women. Women need to have access to diverse HIV prevention strategies from which they can choose one or more that speak to their life experiences and cultural context. Multilevel HIV prevention strategies individual, couples, community, and macrolevel are needed for African American women to deal with co-occurring risk factors; social, economic, and gender inequalities; and social norms related to sexuality and HIV risks.
National Center for Biotechnology Information , U. Am J Public Health. Caldeira , PhD, Lesia M. Author information Article notes Copyright and License information Disclaimer. Nabila El-Bassel, Nathilee A. Caldeira, Lesia M. Corresponding author. Contributors N. Accepted November 3, This article has been cited by other articles in PMC.
Approaches to Solutions African American women with substance abuse problems are more likely to have experienced co-occurring childhood sexual abuse, IPV, and PTSD than women with no history of substance abuse and may not benefit from HIV prevention strategies that do not consider these co-occurring problems and their relationship to risky behaviors.
EXOSYSTEM Compared with African American women of higher socioeconomic status, those of lower socioeconomic status are exposed to more frequent, more severe, and chronic stressors including unemployment, homelessness, victimization, and exposure to community violence.
Approaches to Solutions Very few preventive strategies fully address the social and economic situations that African American women live in, and this reduces their effectiveness in helping these women to successfully incorporate and utilize the strategies offered. Approaches to Solutions Although preventive strategies have addressed issues of power imbalances, there is a continued need for effective HIV prevention strategies for African American women that challenge the existing gender inequalities and teach women ways to combat these issues without increasing their risk of violence and HIV infection.
Social Norms and Beliefs Studies suggest that social norms family, peer, community, society can also have a significant impact on whether African American women implement HIV protective behaviors.
Approaches to Solutions To date, African American women have little access to evidence-based prevention strategies that address social norms and beliefs around sexuality and HIV infection. Human Participant Protection No protocol approval was needed for this article.
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