The Context of HIV Risk Among Drug Users and Their Sexual Partners

Hispanic women but extramarital affairs and frequent sex with other men
for men (Magana and Magana 1992). For example, it has been estimated
that approximately 30 percent of Hispanic men have engaged in sex with
other men (Carrier 1985). An interesting but unanswered question
concerns the degree to which women know about their husbands’
behavior or admit it to themselves; however, it is clear that discussions on
this topic are very difficult for many women, making it difficult for them
to protect themselves.
It is widely believed that Hispanic women have a strong religious
orientation and that Roman Catholic doctrine has tremendous influence
upon their life decisions (Marin and Mat-in 1991). It often is assumed
that they will follow papal decrees regarding birth control and condom
use. However, contemporary studies indicate that Hispanic women use
contraception, and being Catholic is not necessarily associated with
traditional reproductive behavior (Marin and Marin 1991). In addition,
folk and spiritualistic beliefs regarding health are held by many
Hispanics. A recent study of HIV-infected Hispanics living in New
Jersey identified prevalent beliefs in folk and spiritualistic causes and
treatments for AIDS (Suarez et al. 1993).
Thus, data exist both to support the existence of cultural factors in HIV
transmission as well as to dispel myths about cultural stereotypes. It is
very important for anyone working in the area of AIDS prevention both
to attend to cultural factors that may moderate intervention effectiveness,
but also to question preexisting assumptions about the cultural
characteristics of the group with which they are working.
Male condoms have been a primary focus of most AIDS education and
behavior change efforts in the United States. Thus, cultural factors
influencing attitudes toward condoms may be especially pertinent for
AIDS prevention. A number of investigators have studied beliefs and
attitudes of at-risk women toward male condoms; the next section is
devoted to a review of this research.
Condom Beliefs and Attitudes
A number of investigators working within the frameworks of the theory
of reasoned action (Fishbein and Middlestadt 1989; Fisher and Fisher
1992; Jemmott and Jemmott 1991) and social cognitive theory (Bandura
1992; O’Leary 1992) have identified beliefs and attitudes related to safer
sex in women. Perceptions of risk have been associated with greater
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