fear of abuse or experience of abuse deter women from discussing condom use with male partners, as well as how women cope with such fear. The work of Gomez and Marin (1993) for example, suggests that fear of the partner's anger in response to requests to use condoms is an important predictor of condom use among Hispanic/Latina women.

Motherhood is another gender-specific issue to consider. Many women in the United States who are HIV positive are both African American or Hispanic/Latina and mothers. It is thus essential to recognize the centrality that motherhood plays in the lives of these women. For many African American and Hispanic/Latina women, the role of mother is the primary pathway to greater social status and respect in their communities. Particularly for those women devalued because of their drug-using status, the role of mother takes on added importance (Wermuth, Ham, and Robbins, 1992). Inconsistent use of birth control and condoms and ambivalence about abortion may contribute to difficult and problematic decision making about pregnancy. Many women are torn between the value placed on children and motherhood and the possibility that the child may be born HIV positive. In addition, many who are taught to place the care of others before their own needs do not take the steps necessary to foster their own well-being, a problem exacerbated by the fact that they are also less likely to have the support of a mate once they become infected with HIV. As a consequence, the support network of HIV-positive women may be more constricted than that of other AIDS patients. Their unfavorable financial position bars them from obtaining the expensive drugs needed to treat AIDS and prevents them from traveling long distances for the limited amount of care that may be available to them. They are also consumed by worry over the care of their children after they die, given that foster care systems are already overwhelmed and given the likelihood that children who are HIV positive may suffer even greater discrimination in placement.

In sum, in the collective effort to prevent HIV infection, strategies employed without an understanding of the social conditions that facilitate HIV infection—such as poverty, discrimination, and inequality between women and men—may ultimately be ineffective. Increasingly, it will be important to investigate the interactions of such social conditions with psychological and neurobiological factors that possibly together influence the behavior of individuals.



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