Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Aimee E. Ferraro



The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and self-efficacy in condom use among middle-income AA women. One hundred and fifty two middleincome AA women were recruited through personal social media accounts and Survey Monkey to participate in this study. Multiple linear regression analyses indicated that 4 of the 5 constructs (i.e. perceived benefits, perceived barriers, cues to action, relationship self-efficacy) were predictors of self-efficacy in condom use, after controlling for age, income, education attainment, and marital status. There was no association between perceived threat and self-efficacy in consistent condom use. The results can inform HIV prevention counseling at the primary care level to reduce the spread of HIV among all AA women. Implications for positive social change include evidence for the need to expand the paradigm for HIV prevention interventions to include middle-income AA women and restructure HIV prevention strategies to address all women of color in the

United States.