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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.075747v1 97/1/125    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Hallfors, D. D. Articles by Bauer, D. J. Search for Related Content PubMed PubMed Citation Articles by Hallfors, D. D. Articles by Bauer, D. J. Related Collections Epidemiology HIV/AIDS African Americans/Blacks Other Race/Ethnicity Sexual Health

Denise Dion Hallfors, PhD, Bonita J. Iritani, MA, William C. Miller, MD, PhD, MPH and Daniel J. Bauer, PhD

Denise Dion Hallfors and Bonita J. Iritani are with the Pacific Institute for Research and Evaluation, Chapel Hill, NC. William C. Miller is with the Departments of Epidemiology and Medicine, University of North Carolina, Chapel Hill. Daniel J. Bauer is with the Department of Psychology, University of North Carolina, Chapel Hill.

Correspondence: Requests for reprints should be sent to Denise Dion Hallfors, PhD, 1516 E Franklin St, Suite 200, Chapel Hill, NC 27514 (e-mail: hallfors{at}pire.org).

Objectives. We used nationally representative data to examine whether individuals’ sexual and drug behavior patterns account for racial disparities in sexually transmitted disease (STD) and HIV prevalence.

Methods. Data were derived from wave III of the National Longitudinal Study of Adolescent Health. Participants were aged 18 to 26 years old; analyses were limited to non-Hispanic Blacks and Whites. Theory and cluster analyses yielded 16 unique behavior patterns. Bivariate analyses compared STD and HIV prevalences for each behavior pattern, by race. Logistic regression analyses examined within-pattern race effects before and after control for covariates.

Results. Unadjusted odds of STD and HIV infection were significantly higher among Blacks than among Whites for 11 of the risk behavior patterns assessed. Across behavior patterns, covariates had little effect on reducing race odds ratios.

Conclusions. White young adults in the United States are at elevated STD and HIV risk when they engage in high-risk behaviors. Black young adults, however, are at high risk even when their behaviors are normative. Factors other than individual risk behaviors and covariates appear to account for racial disparities, indicating the need for population-level interventions.

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