Just as class and ethnic concerns are related to the discourse on sexuality, they also affect the definition and treatment of social problems. Looking at culture, class, ethnicity, and variations in sexualities is important in developing models of sexuality that have practical applicability. Ignoring within group differences has seriously undermined efforts to prevent HIV infection among women (Amaro, 1995). Whereas most men contract HIV from homosexual activity, most women contract HIV from drug use or heterosexual contact. Not only do women contract HIV through the use of infected needles, but women who use drugs are more likely to engage in high risk sexual behaviors. Furthermore, prevention programs often do not consider the role of gender and assume that the use of condoms, the decision when and if to have sexual contact, and the meaning of sexual activities are the same for men and women. Whereas a man decides to wear or not wear a condom, a woman decides whether to ask a man to wear a condom and whether to refuse sex if he does not. Theoretical models and prevention programs also disregard the fact that women do not always have a choice about sexual activity and that women grow up in a society that encourages them to be passive sexual partners in relationships where they have less power than their partner. Hortensia Amaro (1995) encourages researchers to integrate into theoretical models of HIV risk behavior women’s social status, the importance of relationships to women, the role of male partners and the male gender role, and women’s fear of and experiences with abuse.
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