Factors Associated with Inconsistent Condom Use Among Migrant and Immigrant Hispanic Women in the United States

Background: Due to a high prevalence of sexual risk behaviors, migrant and immigrant Hispanic women are at increased risk for infection by HIV or other sexually transmitted diseases (STDs).

Objectives:To better understand factors associated with inconsistent condom use (ICU) that may assist in tailoring HIV/STD prevention interventions for this population.

Methods: From March 2005 to February 2007, 1081 participants were recruited from among women who received an HIV test at community-based organizations offering services to migrant and immigrant communities in Georgia, Connecticut, Wisconsin, Minnesota, and South Dakota. Women were interviewed to collect demographic characteristics, sexual risk behaviors, and STD diagnoses in the past year. Separate multiple logistic regression models were used to investigate factors independently associated with ICU during vaginal and anal sex in the past 12 months.

Results: Of 1015 women reporting sex with a man in the past 12 months, 445 (44%) reported ICU during vaginal sex, 118 (12%) reported ICU during anal sex, 50 (5%) had received an STD diagnosis, and 1 (0.1%) tested positive for HIV. Women who reported knowing the HIV status of their sex partner had 4.5 times the odds (95% Confidence Interval [CI]=2.9-6.8) of reported ICU during vaginal sex than those who did not. Additionally, participants reporting sex with a person who uses injection street drugs, having anonymous sex, and transactional sex had 3.1 times (95% [CI]=1.3-7.0), 3.1 times (95% [CI]=1.4-6.4), and 4.2 times (95% [CI]=1.7-10.2) the odds, respectively, of reported ICU during anal sex than those who did not report those behaviors.

Conclusions: Several high risk sexual behaviors were associated with ICU during anal sex. Knowledge of partner’s serostatus was associated with ICU during vaginal sex.

Implications for Programs, Policy, and/or Research: HIV/STD programs should stress consistent condom use during anal sex for migrant/immigrant Hispanic women engaging in high-risk sexual behaviors identified in this study.