Some women may be unaware of their male partner’s risk factors for HIV (such as injection drug use or having sex with other men) and may not use condoms.
The risk of getting HIV during vaginal sex without a condom or other protection such as PrEP is much higher for women than it is for men, and anal sex without a condom or PrEP is riskier for women than vaginal sex without a condom or PrEP. More than 20% of women aged 20 to 39 who responded to a national survey reported anal sex in the past year.
Women may be afraid that their partner will leave them or even physically abuse them if they try to talk about condom use.
Some sexually transmitted diseases (STDs), such as gonorrhea and syphilis, greatly increase the likelihood of getting or spreading HIV.
Women who have been sexually abused may be more likely than women with no abuse history to engage in sexual behaviors like exchanging sex for drugs, having multiple partners, or having sex with a partner who is physically abusive when asked to use a condom.
Some HIV infections among women are due to injection drug and other substance use—either directly (sharing drug injection equipment contaminated with HIV) or indirectly (engaging in high-risk behaviors while under the influence of drugs or alcohol).
The greater number of people living with HIV (prevalence) in African American and Hispanic/Latino communities and the fact that people tend to have sex with partners of the same race/ethnicity means that women from these communities face a greater risk of HIV infection with each new sexual encounter.