Sexual and Drug Behavior Patterns and HIV/STD Racial Disparities: The Need for New Directions
Denise Dion Hallfors 1*,Bonita J. Iritani 2,William C. Miller 3,Daniel J. Bauer 4
1 PIRE 2 Pacific Institute for Research and Evaluation 3 UNC Chapel Hill 4 The University of North Carolina at Chapel Hill
* To whom correspondence should be addressed. E-mail: hallfors{at}pire.org.
Abstract
Objectives. We used nationally representative data to examinewhether individuals sexual and drug behavior patternsaccount for racial disparities in sexually transmitted disease(STD) and HIV prevalence.
Methods. Data were derived from waveIII of the National Longitudinal Study of Adolescent Health.Participants were aged 18 to 26 years old; analyses were limitedto non-Hispanic Blacks and Whites. Theory and cluster analysesyielded 16 unique behavior patterns. Bivariate analyses comparedSTD/HIV prevalences for each behavior pattern, by race. Logisticregression analyses examined within-pattern race effects beforeand after control for covariates.
Results. Unadjusted odds ofSTD/HIV infection were significantly higher among Blacks thanamong Whites for 11 of the risk behavior patterns assessed.Across behavior patterns, covariates had little effect on reducingrace odds ratios.
Conclusions. White young adults in the UnitedStates are at elevated STD/HIV risk when they engage in high-riskbehaviors. Black young adults, however, are at high risk evenwhen their behaviors are normative. Factors other than individualrisk behaviors and covariates appear to account for racial disparities,indicating the need for population-level interventions.
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