Abstract
BackgroundThe feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States. The steadily changing demographic profile of the AIDS epidemic challenges prevention strategies to remain relevant and up-to-date, particularly in populations of women midlife and older where an understanding of risk remains under explored. As the CDC requests country-specific HIV risk profiles for Latino communities in the US, understanding the socio-economic, behavioral and personal risk reasons of HIV risk for older Dominican women is critical for prevention.MethodsWe conducted focus group discussions informed by the Theory of Gender and Power (TGP). The three constructs of the TGP: 1) Affective influences/social norms; 2) Gender-specific norms and.3) Power and Authority guided the thematic analysis and identified themes that described the socio-cultural and contextual reasons that that contribute to perceptions of HIV risk.ResultsSixty Dominican American women ages 57–73 participated in our focus group discussions. Sexual Division of Labour: 1) Economic Dependence; 2) Financial Need and 3) Education and Empowerment. Sexual Division of Power: 4) HIV Risk and 5) Relationship Dynamics. Cathexis: Affective Influences/Social Norms: 6) HIV/AIDS Knowledge and 7) Prevention and Testing. Importantly, participants were concerned about partner fidelity when visiting the Dominican Republic, as the country accounts for the second highest HIV rates in the Caribbean.ConclusionsOur results confirm previous findings about perceptions of HIV risk and provide additional insight into aging-related aspects of HIV risk for Latino women midlife and older.
Highlights
The feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States
Men account for 87% of new HIV infections in United States (US) Latino communities, disturbing trends emerge among women [1, 2]
Most were born in the Dominican Republic (86.9%) and reported their primary language as Spanish (100%)
Summary
The feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States. The steadily changing demographic profile of the AIDS epidemic challenges prevention strategies to remain relevant and up-to-date, in populations of women midlife and older where an understanding of risk remains under explored. Considerable measurement errors exists to capture demographic characteristics, beliefs and attitudes in studies of younger women, where a variety of other reasons contribute to risk behavior (e.g., pregnancy) [9, 11] This results in the inability to quantify and relate observed effects to women midlife and older [5]. The sexual revolution of the 60s and 70s, led to different beliefs regarding sexual expression among baby boomers [12] These and other steadily changing reasons associated in the demographic profile of the AIDS epidemic, challenges HIV prevention strategies to remain relevant and up-todate [13]. Knowledge gaps can leave health professionals ill-prepared to effectively discuss HIV/AIDS prevention [3, 4, 16]
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