Sociodemographic, HIV Risk Behavior and Attitudinal Characteristics that Discriminate Urban, Crack-Using African-American Men Reporting Involvement in Concurrent Sexual Partnerships Pages 7-18

Robert C. Freeman

Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, U.S. National Institutes of Health, 5635 Fishers Lane, Room 2073 MSC 9304, Bethesda, MD 20892-9304, Fed Ex: Rockville, MD 20852-1705, USA

DOI: http://dx.doi.org/10.12970/2309-0529.2013.01.01.2

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Abstract: A number of studies have found that involvement in concurrent sexual partnerships (sexual partnerships that overlap in time) increases sexually transmitted infection (STI) risk, and that such partnerships may be a major determinant of the rate of human immunodeficiency virus (HIV) spread. In the U.S., such partnerships may be relatively more common among African-Americans than among other racial groups, likely reflective of the sizable “shortage” of African-American males in inner-city locales—as well as in some rural areas, such as the U.S. South—largely attributable to this group’s relatively higher rates of incarceration and other forms of institutionalization, military enlistment, and mortality. Concurrent partnerships also may be relatively common arrangements among crack cocaine users, who frequently report high numbers of sexual partners and often have been found to report elevated HIV rates. While studies have found sexual concurrency to be associated with a host of sociodemographic, sexual history, and behavioral characteristics, relatively little has been published detailing the norms, attitudes, and psychological functioning of those who maintain concurrent partnerships. Utilizing a high risk (for HIV) sample of 152 not-in-treatment male African-American crack cocaine smokers recruited from street settings in 2 major U.S. cities, this study attempts to identify those variables—from amongst measures of sociodemographics, drug use and sexual behavior, condom use attitudes, primary relationship norms, and psychological and social functioning—that discriminate men who are and are not involved in concurrent sexual partnerships. Nearly half of the study sample reported being regularly sexually involved with both a main partner and at least one casual partner. However, little evidence was found to suggest that such involvement is indicative of overarching deficits in mental health or of unusual deviation from prevailing community behavioral norms, nor was evidence found suggesting that sexual concurrency is a marker for inveterate risk taking across other dimensions of HIV risk behavior. Implications for preventive intervention development are discussed.

Keywords: Concurrent partnerships, crack use, African American, HIV risk behavior, not-in-treatment. Read more →