Socioeconomic, cultural, and gender barriers limit the ability of some young women of color to receive information on sexually transmitted infections (STIs), including HIV, access culturally appropriate health care, and reduce sexual risks.
Statistics by ethnicity can be misleading due to relationships between socioeconomic status and ethnicity; yet, illuminating the epidemiology of HIV in different populations may promote prevention efforts in under-served communities. The estimated prevalence of HIV and other STIs is especially high for young women of color many of whom lack health insurance and have little or no access to health care. A lack of well-funded prevention programs specifically addressing young women of color further limits the capacity of some these young women to protect themselves against HIV infection.
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Behavioral and Socioeconomic Factors Negatively Affect the Health of Young
Women of Color
Poverty and access to care—Young women of color are
disproportionately members of the working poor who often lack access to
affordable, culturally sensitive, and youth-friendly health services. As a
result many YWOC receive little preventive health information, including
strategies that reduce their risk for HIV infection.
contact—The largest category for being infected with HIV among women of
color is heterosexual contact—having sex with a man who uses injection drugs, is
HIV-infected, or whose HIV status is unknown to the young woman. For example, in
2002 among cumulative HIV/AIDS cases, 77 percent of Asian and Pacific Islander
women, 74 percent of African American women, 72 percent of Latinas, and 62
percent of Native American women reported heterosexual contact as their risk
Communication — Patterns of communication about
sexuality differ by ethnicity, age, socioeconomic status, and level of
acculturation. Reticence in discussing sexuality occurs among minority
populations as frequently as among the U.S. population as a whole. Some Asian
Pacific Islander and Latino cultures prohibit or discourage open discussion of
topics like condom use, disease, and sexual behaviors. African American
adolescent females, on the other hand, report receiving information about and
discussing HIV and sexuality at school and with family. Young African American
women also report feeling comfortable in assertively asking about partners’ past
sexual risks, although they are often reluctant to ask about same-sex sexual
behavior or substance use—behaviors of male partners that can put the young
women most at risk.
Cultural discomfort with conversations about
sexuality and sexual behaviors poses difficulties for some young women of color
as they attempt to negotiate safer sex practices and set limits with a sex
partner. Numerous studies indicate that African American women and Latinas are
concerned about HIV infection but may not use condoms. While most young women of
color report a strong desire to use condoms, those who have low incomes
frequently report fear, discomfort, and intimidation about negotiating condom
use with their sexual partner. Some young women fear that young men will be
angered or offended by questions about past risk behaviors and by requests that
they use condoms.