Sociodemographic and behavioral characteristics of African-American women with HIV and AIDS in Los Angeles County, 1990-1997.

African-American women have the highest AIDS rate of any racial/ethnic group of women in both Los Angeles County (LAC), California and in the United States. Limited population-based epidemiologic studies of African-American women with HIV and AIDS describe this group and examine the factors associated with the excessive rates. Interview data collected from 1990 to 1997 on a population-based sample of AIDS cases and a group of HIV-infected women in LAC were analyzed to highlight the sociodemographic and behavioral characteristics of African-American women. This group of African-American women with HIV or AIDS in LAC were unemployed (88%), single mothers (64%), living on public assistance (86%) with annual household incomes <$10,000 U.S. (76%). A history of crack use predominated (50%). Compared with women of other races with HIV and AIDS, African-American women reported more sexual partners; reported more infections with sexually transmitted diseases; sought treatment for their HIV infection later; were more likely to trade sex; and were almost five times more likely to have ever used crack cocaine. HIV prevention for African-American women in LAC should focus on improving self-esteem and negotiation skills within the context of the crack cocaine culture and the disadvantaged social and economic situation described.