Perceived stability may impact HIV risk among women

ATLANTA – Women who perceive themselves to be stable in terms of factors such as housing, employment and income may be less likely to engage in risky sexual behaviors, according to findings presented at the 2009 National HIV Prevention Conference.

Results of the study, which involved 409 low-income urban women and members of their female social network, were presented by Danielle German PhD, MPH, of the Johns Hopkins Bloomberg School of Public Health.

“Factors like homelessness, incarceration, employment, social isolation and transience impact each other,” German said. “We attempted to separate them out.”

All participants were interviewed after they had completed a 12-month HIV prevention intervention program in Baltimore. “Before we began the study and once we started conducting interviews, we heard a common language with common terms: chaos, constant uncertainty, instability, difficulty in taking things for granted, a feeling of being out of control,” she said. “We wanted to measure this feeling of chaos versus what is actually happening in those circumstances.”

German and her colleagues developed a set of five items based on psychometric tests. The researchers sought to determine how well the items on the list of perceived stability factors related to each other and how this scale related to other similar measures of HIV risk.

Higher perceived stability was associated with several objective indicators of social stability, including housing stability, employment, residential transience and higher income, according to the findings.

Using age and education as control factors, associations between higher perceived stability and decreased likelihood of multiple sexual partners, sex exchange, sex while high and any partner risk were observed.

“On top of these findings, we found that drug use and depression also were associated with higher levels of uncertainty,” German said.

German said that a brief scale of perceived stability may be effective in conducting HIV prevention research and evaluation efforts. This scale also may more effectively assess the needs of individuals in social service settings. “A measure of perceived stability was actually aligned with actual instability in the lives of our participants,” she said. “We then found that actual chaos was associated with a higher risk. A focus on addressing factors that contribute to perceived stability may reduce sexual risk behaviors.”