Ralph DiClemente
Ralph DiClemente
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Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Ralph DiClemente was trained as a Health Psychologist at the University of California, San Francisco where he received his PhD in 1984 after completing a ScM at the Harvard School of Public Health. He earned his undergraduate degree at the City University of New York.
Dr. DiClemente’s research has four key foci:
- Developing interventions to reduce the risk of HIV/STD among vulnerable populations
- Developing interventions to enhance vaccine uptake among high-risk adolescents and women, such as HPV and influenza vaccine
- Developing implementation science interventions to enhance the uptake, adoption and sustainability of HIV/STD prevention programs in the community
- Developing diabetes screening and behavior change interventions to identify people with diabetes who are unaware of their disease status as well as reduce the risk of diabetes among vulnerable populations.
He has focused on developing intervention packages that blend community and technology-based approaches that are designed to optimize program effectiveness and enhance programmatic sustainability.
Dr. DiClemente is the author of ten CDC-defined, evidence-based interventions for adolescents and young African-American women and men. He is the author of more than 540 peer-review publications, 150 book chapters, and 21 books. He serves as a member of the Office of AIDS Research Advisory Council.
Previously, Dr. DiClemente served as the Charles Howard Candler Professor of Public Health at the Rollins School of Public Health at Emory University. He was also Associate Director of the Center for AIDS Research, and was previously Chair of the Department of Behavioral Sciences and Health Education at the Rollins School of Public Health.
Dr. DiClemente is Past President of the Georgia chapter of the Society for Adolescent Health & Medicine. He previously served as a member of the CDC Board of Scientific Counselors, and the NIMH Advisory Council.
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Education
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BA, The City College of the City University of New York (CCNY), New York, NYScM, Behavioral Sciences, Harvard University, Cambridge, MAPhD, Health Psychology, University of California San Francisco Center for Behavioral Sciences, San Francisco, CAPostdoctoral Fellow, University of California, San Francisco, CA
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Areas of research and study
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Community InterventionsDiabetesHIV/AIDSImplementation scienceInfluenzaPsychology
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Publications
Publications
Adverse consequences of intimate partner abuse among women in non-urban domestic violence shelters
AbstractWingood, G. M., DiClemente, R., & Raj, A. (n.d.).Publication year
2000Journal title
American journal of preventive medicineVolume
19Issue
4Page(s)
270-275AbstractObjective: This study examined the health consequences of having experienced both sexual and physical abuse relative to women experiencing physical abuse but not sexual abuse. Methods: A cross-sectional study was conducted among 203 women seeking refuge in battered women's shelters. Controlling for sociodemographics, logistic regression analyses were conducted to assess the consequences of experiencing both sexual and physical abuse. Results: Compared to women experiencing physical abuse, women experiencing both sexual and physical abuse were more likely to have a history of multiple sexually transmitted diseases (STDs) in their abusive relationships, have had an STD in the past 2 months, be worried about being infected with HIV, use marijuana and alcohol to cope, attempt suicide, feel as though they had no control in their relationships, experience more episodes of physical abuse in the past 2 months, rate their abuse as more severe, and be physically threatened by their partner when they asked that condoms be used. Conclusions: Given the prevalence of adverse health outcomes, domestic violence shelters could counsel women to avoid using alcohol/drugs as a coping strategy, educate women about alternative healthy coping strategies, counsel women about methods of STD prevention that they can control, and provide STD screening and treatment. (C) American Journal of Preventive Medicine.Application of the Theory of Gender and Power to Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
2000Journal title
Health Education & BehaviorVolume
27Issue
5Page(s)
539-565AbstractDeveloped by Robert Connell, the theory of gender and power is a social structural theory based on existing philosophical writings of sexual inequality and gender and power imbalance. According to the theory of gender and power, there are three major social structures that characterize the gendered relationships between men and women: the sexual division of labor, the sexual division of power, and the structure of cathexis. The aim of this article is to apply an extended version of the theory of gender and power to examine the exposures, social/behavioral risk factors, and biological properties that increase women's vulnerability for acquiring HIV. Subsequently, the authors review several public health level HIV interventions aimed at reducing women's HIV risk. Employing the theory of gender and power among women marshals new kinds of data, asks new and broader questions with regard to women and their risk of HIV, and, most important, creates new options for prevention.Correlates of unprotected vaginal sex among African American female adolescents : Importance of relationship dynamics
AbstractCrosby, R. A., DiClemente, R., Wingood, G. M., Sionéan, C., Cobb, B. K., & Harrington, K. (n.d.).Publication year
2000Journal title
Archives of Pediatrics and Adolescent MedicineVolume
154Issue
9Page(s)
893-899AbstractObjective: To determine the associations between the frequency of unprotected vaginal sex (UVS) and female adolescents' perceptions, particularly their perceptions of relationship dynamics. Design: Cross-sectional study of 522 African American female adolescents enrolled in a sexually transmitted disease (STD) and human immunodeficiency virus prevention intervention trial. Setting and Participants: A volunteer sample of adolescents recruited from neighborhoods characterized by high rates of unemployment, substance abuse, violence, and STDs; 28% tested positive for STDs as assessed by DNA amplification or culture. Main Outcome Measure: Frequency of UVS assessed by interview using a 6-month recall period. Results: Among adolescents having steady relationships, those spending more time with their boyfriends and having longer relationships reported a significantly greater frequency of UVS. Other significant correlates included perception of more girlfriends using condoms, no history of STDs, stronger normative beliefs favoring male decision making in relationships, greater pregnancy worry, and greater perceived invulnerability to STDs. For adolescents reporting casual relationships, personal barriers to condom use, no history of STDs, and reporting that their boyfriends typically decide when to have sex were associated with more frequent UVS. Conclusions: Adolescents' perceptions, particularly their perceptions of relationship dynamics, played an integral role in explaining female adolescents' frequency of UVS with both steady and casual partners. Female adolescents in steady relationships differ from those in casual relationships relative to their prevention needs. These findings have implications for clinic- or community-based STD and human immunodeficiency virus prevention programs.Drug use and HIV risk-related sex behaviors : A street outreach study of black adults
AbstractWang, M. Q., Collins, C. B., Kohler, C. L., DiClemente, R., & Wingood, G. (n.d.).Publication year
2000Journal title
Southern Medical JournalVolume
93Issue
2Page(s)
186-190AbstractBackground. Our street outreach project investigated the relationship between use of noninjecting drugs (alcohol, marijuana, cocaine) and human immunodeficiency virus (HIV) risk-related sex behaviors of black adults. The study focused on three HIV-related risks: multiple sex partners, unprotected sex, and drugs during sex. Methods. Data for this study were collected in a street outreach community survey for a drug abuse and HIV intervention study in Birmingham, Ala. A total of 780 black men and women completed the survey. Results. High-risk sex behaviors were far more prevalent among cocaine users than marijuana or alcohol users. A greater number of cocaine users reported having multiple sex partners, not using condoms, and using drugs during sex. Female cocaine users showed the same risk level for HIV infection as male cocaine users. Conclusions. Increased risk of HIV infection through sexual transmission is associated with use of noninjecting cocaine for both men and women. Condom use should be considered as a major component of HIV prevention programs.Expanding the scope of HIV prevention for adolescents : Beyond individual-level interventions
AbstractDiClemente, R. J., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
2000Journal title
Journal of Adolescent HealthVolume
26Issue
6Page(s)
377-378Abstract~Health care service use and sexual communication : Past experience and future intention of high-risk male adolescents
AbstractRoberts, J., Boker, J. R., Oh, M. K., & DiClemente, R. (n.d.).Publication year
2000Journal title
Journal of Adolescent HealthVolume
27Issue
5Page(s)
298-301AbstractHigh-risk male adolescents were surveyed to collect data to be used to develop strategies to enhance communication with their partners about sexually transmitted diseases (STDs). Participants were concerned about acquiring an STD from their partner, and reported an increased likelihood of communicating about STD-related issues when confidential health care was available. Copyright (C) 2000 Society for Adolescent Medicine.Hepatitis B vaccination in a high risk MSM population : The need for vaccine education [4]
AbstractRhodes, S. D., DiClemente, R. J., Yee, L. J., Hergenrather, K. C., & DiClemente, R. (n.d.).Publication year
2000Journal title
Sexually transmitted infectionsVolume
76Issue
5Page(s)
408-409Abstract~High prevalence of asymptomatic STDs in incarcerated minority male youth : A case for screening
AbstractPack, R. P., DiClemente, R., Hook, E. W., & Oh, M. K. (n.d.).Publication year
2000Journal title
Sexually Transmitted DiseasesVolume
27Issue
3Page(s)
175-177AbstractBackground and Objectives: To assess STD prevalence among a sample of incarcerated minority male youth in a southern US city. Methods: A consecutive entrant, cross-sectional study of 284 minority males 14 to 18 years was performed. All adolescents were screened for gonorrhea and chlamydia using ligase chain reaction tests. Results: Eighteen percent of youth were identified as having either gonorrhea, chlamydia, or both. Approximately 84% of those with sexually transmitted diseases (STDs) self- reported having no symptoms. Failure to use condoms in the past month was significantly associated with a positive test result for STDs (odds ratio = 1.9, 95% CI = 1.1-3.3). Conclusions: The findings indicate an urgent need for routine STD screening and STD-prevention programs for adolescent males in detention facilities. A study of 284 detained black male adolescents revealed 18% prevalence of gonorrhea, chlamydia, or both. Approximately 84% of those with sexually transmitted diseases self-reported not having symptoms.Identifying the prevalence and correlates of stds among women residing in rural domestic violence shelters
AbstractWingood, G. M., DiClemente, R., & Raj, A. (n.d.).Publication year
2000Journal title
Women and HealthVolume
30Issue
4Page(s)
15-26AbstractThe present study uses a cross-sectional study design to assess the prevalence and abuse-related correlates of STDs among women (n = 203) residing in rural and nonurban domestic violence shelters, a venue in which health care providers could intervene by providing STD prevention counseling, diagnosis and treatment. To our knowledge, this is the first study to examine the prevalence and correlates of self-reported STDs among women residing in domestic violence shelters. In this sample, 99% of women reported being physically abused in the prior 2 months, 55% reported being sexually abused and 43% reported being raped. Further, 33% of women reported acquiring an STD during their abusive relationship, 13.3% reported acquiring multiple STDs and 9.2% reported acquiring an STD in the 2 months prior to entering the shelter. In this sample having a history of rape, having an unfaithful partner and fear negotiating condom use were all associated with having an STD history. Coordinating STD services with domestic violence shelters could reach a high-risk population that is not traditionally targeted by STD programs, could increase early detection of STDs, may increase access to and improve the quality of STD-related care, particularly among rural populations, and could be cost-effective.Reconceptualizing Women's HIV Risk
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
2000Journal title
Health Education & BehaviorVolume
27Issue
5Page(s)
570-571Abstract~STAND : A peer educator training curriculum for sexual risk reduction in the rural south
AbstractSmith, M. U., & DiClemente, R. (n.d.).Publication year
2000Journal title
Preventive MedicineVolume
30Issue
6Page(s)
441-449AbstractBackground. The incidence of AIDS in rural areas continues to increase rapidly, with teenagers continuing to report high rates of sexual risk behaviors. Unfortunately, there is a dearth of effective HIV prevention programs targeting youth in rural settings where there are often formidable barriers to sex education programs. This paper describes a theoretically based intervention designed to meet the needs of rural youth. Methods. Students Together Against Negative Decisions (STAND) is a 28-session teen peer educator training program implemented in a rural county in a southeastern state, promoting both abstinence and sexual risk reduction. The theoretical foundation of the curriculum includes both Diffusion of Innovations Theory and the Transtheoretical Model, focusing on both individual and community norm change. STAND is teen-centered and skills- based; activities focus on active learning. Educator trainees are selected on the basis of their opinion leadership within their peer group, resulting in a training group of both virgin and sexually active teens, balanced for gender and matched to the racial proportions of the school. Results. Acceptance and participation in STAND suggest that adolescents in rural communities can be accessed through community-based interventions, that they are willing to participate in such intensive programs, and that they perceive the intervention as valuable and enjoyable. Moreover, the STAND program has thrived in a relatively conservative rural environment, and has had a positive impact on adolescents' sexual risk taking. Results from a pilot study showed significantly greater increases in condom use self-efficacy (16% vs a 1% decrease among controls) and in consistent condom use (+28% vs +15%). Adolescent trainees also reported a sevenfold larger increase in condom use (+213% vs +31%) and a 30% decrease in unprotected intercourse compared to a 29% increase among controls. Conclusions. STAND represents a new genre of HIV prevention program, one that utilizes complementary theoretical models to develop a program that targets both individual- and community-level change for rural adolescents. (C) 2000 American Foundation and Academic Press.Abstinence and safer sex among adolescents [1] (multiple letters)
AbstractBerman, S. M., Gunn, R. A., Aral, S. O., Cameron, P., Cameron, K., Panzer, R. A., Moore, T. L., Masdeu, J. C., Jemmott, J. B., Jemmott, L. S., Fong, G. T., & DiClemente, R. (n.d.).Publication year
1999Journal title
Journal of the American Medical AssociationVolume
281Issue
16Page(s)
1485-1488Abstract~Adolescents and HIV : Theory-based approaches to education of nurses
AbstractStewart, K. E., DiClemente, R., & Ross, D. (n.d.).Publication year
1999Journal title
Journal of Advanced NursingVolume
30Issue
3Page(s)
687-696AbstractHIV infection is increasingly prevalent in adolescents, and primary prevention programmes have been most effective when based on existing theories, including social cognitive theory (SCT). Nurses play an important role in assessing adolescents' risk for HIV infection and in recommending preventive behaviour change, if their comfort with these activities is increased. Practising nurses (n = 88, mean age = 40-8) from a university medical centre and surrounding hospitals participated in either a didactic or SCT-based workshop and a vignette-based assessment. Utilizing a randomized controlled design, this study compared the effectiveness of the two types of workshops by measuring HIV-related knowledge and attitudes, as well as comfort with and intent to perform HIV-related risk assessments. Differences in comfort and intent based on target patients' cultural descriptors were also evaluated. The SCT-based workshops yielded more positive results for all four outcome variables at the 8-week follow-up (F2,71 = 4.27, P < 0.02). Cultural stereotyping also appeared to play a role in nurses' intent to perform assessments (F2,74 = 11.81, P < 0-001). Suggestions for improving the workshops and incorporating other theory-based approaches are discussed.Aids knowledge among black drug users : An issue of reliability
AbstractWang, M. Q., Collins, C. B., Kohler, C. L., DiClemente, R., & Wingood, G. (n.d.).Publication year
1999Journal title
Psychological reportsVolume
84Issue
1Page(s)
121-124AbstractThis study examined the reliability of an inventory measuring AIDS-related knowledge among 553 black drug users. Data were collected from a socially high-risk community in Birmingham, Alabama. The KR-20 reliability scores were computed from the inventory for each drug-use group. The KR-20 reliabilities ranged from .39 to .57. These findings may suggest that the inconsistent reports of the predictive power of AIDS knowledge among drug users reported in previous studies might be related to the low internal consistencies of the inventory.Changes in incarcerated adolescents' human immunodeficiency virus knowledge and selected behaviors from 1988 to 1996
AbstractLanier, M. M., Pack, R. P., & DiClemente, R. (n.d.).Publication year
1999Journal title
Journal of Adolescent HealthVolume
25Issue
3Page(s)
182-186AbstractData were collected from juveniles in Alabama and Florida correctional facilities. The samples were closely demographically matched. Analysis indicated significant increases in knowledge about human immunodeficiency virus between 1988 and 1996 and increased sexual risk behaviors. Knowledge levels were lower for ethnic minority groups and boys, suggesting ethnic- and gender-specific pedagogical aids are needed.Evaluation of the exposure effects of a theory-based street outreach HIV intervention on African-American drug users
AbstractCollins, C., Kohler, C., DiClemente, R., Wang, M. Q., & DiClemente, R. (n.d.).Publication year
1999Journal title
Evaluation and Program PlanningVolume
22Issue
3Page(s)
279-293AbstractThe Street Outreach to Drug Abusers - Community AIDS Prevention (SODA - CAP) Project implemented and evaluated an HIV-prevention intervention aimed at current drug users. The intervention was developed using social cognitive theory and the transtheoretical model of change. The outreach team assessed individuals' stages of change for the target behaviors and they were given stage-appropriate role-model stories. The program effects were evaluated using a quasi-experimental design with a repeated, cross-sectional sampling method in which community surveys were administered at baseline, 12 and 22 months. Multivariate statistical models were developed for four outcomes (condom use with main and other partners, treatment entry, and stopping all drug and alcohol use). Exposure to intervention was a significant predictor for condom use with other partners and for stopping drug and alcohol use.Prevalence and correlates of relationship abuse among a community-based sample of low-income African American women
AbstractAnita, R., Silverman, J. G., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
1999Journal title
Violence Against WomenVolume
5Issue
3Page(s)
272-291AbstractThis study examined the relationship between social and economic power and incidence of male-perpetrated abuse among low-income African American women with partners (N = 102). Relationship abuse was common among participants; 48% reported verbal abuse, threats of physical abuse, or physical abuse in the past 3 months. Findings also illustrated that disempowerment of women, particularly in relationships, increases female vulnerability to abuse. Regression analyses revealed lower education, partner jealousy, and lower partner empathy account for significant variance in relationship abuse in the past 3 months. Results suggest that social and contextual issues must be included in our examination of male abuse of female partners.Sexually transmitted diseases, unintended pregnancy, and adolescent health promotion.
AbstractSantelli, J. S., DiClemente, R. J., Miller, K. S., Kirby, D., & DiClemente, R. (n.d.).Publication year
1999Journal title
Adolescent medicine (Philadelphia, Pa.)Volume
10Issue
1Page(s)
87-108, viAbstractAdolescence is a critical period in the development of sexual behaviors that may lead to acquiring sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and to unintended pregnancy. Understanding adolescent sexual behavior is essential for understanding adolescents' risk of pregnancy and STD/HIV infection and for planning and evaluating health promotion activities. This chapter reviews the sexual behaviors and psychosocial factors associated with STDs and unintended pregnancy among adolescents as well as school-, community-, and clinic-based interventions designed to reduce risk behaviors and promote adolescent sexual health.The psychological basis of health promotion for adolescents.
AbstractDiClemente, R. J., & DiClemente, R. (n.d.).Publication year
1999Journal title
Adolescent medicine (Philadelphia, Pa.)Volume
10Issue
1Page(s)
13-22, vAbstractTemporal trends in adolescent morbidity and mortality and the psychological factors that underlie adolescents' risk-taking behavior are reviewed in this chapter. Theoretical models useful for understanding risk-taking behavior and developing effective preventive interventions are described. Finally, intervention strategies, both on individual and community level, are identified that may enhance adolescent health promotion efforts.Frequency of alcohol use and its association with STD/HIV-related risk practices, attitudes and knowledge among an African-American community-recruited sample
AbstractMorrison, T. C., DiClemente, R., Wingood, G. M., & Collins, C. (n.d.).Publication year
1998Journal title
International Journal of STD and AIDSVolume
9Issue
10Page(s)
608-612AbstractThe aim was to determine the association between frequency of alcohol use in the past 30 days and HIV-related risk behaviours among adults in an African-American community. Data were collected by trained street outreach workers, from 522 persons in 4 areas selected on the basis of 7 health and criminal justice indicators of high risk for HIV, STD and substance abuse, and drug-related arrests. A survey assessed demographics, substance use, sexual behaviour, HIV knowledge, attitudes and depression. Subjects reporting using drugs other than alcohol (n = 201) were excluded from analyses to avoid the confounding influence of polysubstance use. Of the remaining 321 subjects (mean age = 37.1; 58.5% were male), 43.6% reported no alcohol use in the past 30 days, with 37.4% and 19.0%, respectively, having used alcohol 16 days in the past 30 days. Alcohol use frequency (no alcohol, 1-15 days, 16-30 days in past month) was significantly associated with being male, STD history, non-use of condoms, higher perceived risk of HIV, lower condom use self-efficacy, multiple sex partners in the past 30 days, and lower HIV-related knowledge. Frequent alcohol use, in the absence of other drugs, is associated with higher levels of HIV risk behaviours. Though an underserved population with respect to HIV prevention and, given the prevalence of alcohol use, the findings suggest that programmes need to target frequent alcohol users to reduce their HIV-associated risk behaviours and enhance HIV risk-reduction knowledge and attitudes associated with the adoption of HIV prevention practices.Gender-related correlates and predictors of consistent condom use among young adult African-American women : A prospective analysis
AbstractWingood, G. M., DiClemente, R. J., & DiClemente, R. (n.d.).Publication year
1998Journal title
International Journal of STD and AIDSVolume
9Issue
3Page(s)
139-145AbstractThe present study examined the correlates of consistent condom use among African-American women and prospectively evaluated the stability of these significant variables to predict consistent condom use at 3-month follow-up. A sample of 128 African-American women, 18-29 years of age completed a baseline interview and 3 months later completed a similar follow-up interview (n = 100). Compared to women who were inconsistent condom users, women who were consistent condom users were more likely to: have high assertive communication skills (OR = 13), desire not becoming pregnant (OR = 8.6), have high sexual self-control over condom use (OR = 7.6), perceive having control over their partners' use of condoms (OR = 6.6), be younger (OR = 5.8), and report having a partner that was not committed to the relationship (OR = 3.3). Prospective analyses identified baseline level of condom use as the best predictor of condom use at 3-month follow-up. Women who were consistent condom users at baseline were 6.3 times as likely to be consistent condom users at 3-month follow-up. In conclusion, HIV prevention programmes for women need to be gender specific and need to be implemented before high-risk behaviours are established and may be more difficult to modify.Monetary incentives : A useful strategy for enhancing enrolment and promoting participation in HIV/STD risk reduction interventions
AbstractDiClemente, R. J., Wingood, G. M., & DiClemente, R. (n.d.).Publication year
1998Journal title
Sexually transmitted infectionsVolume
74Issue
4Page(s)
239-240Abstract~Partner influences and gender-related factors associated with noncondom use among young adult african american women
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
1998Journal title
American journal of community psychologyVolume
26Issue
1Page(s)
29-51AbstractWe examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likefy to receive AFDC, twice as likefy to be sexually nonassertive, three times more likefy to believe that it was not difficult to find an "eligible" African American man, and three times as likefy to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.Preventing sexually transmitted infections among adolescents : A clash of ideology and science
AbstractDiClemente, R. J., & DiClemente, R. (n.d.).Publication year
1998Journal title
Journal of the American Medical AssociationVolume
279Issue
19Page(s)
1574-1575Abstract~Rape among African American women : Sexual, psychological, and social correlates predisposing survivors to risk of STD/HIV
AbstractWingood, G. M., & DiClemente, R. (n.d.).Publication year
1998Journal title
Journal of Women's HealthVolume
7Issue
1Page(s)
77-84AbstractThe aim of this study was to examine the association of rape of adult African American women and sexual, psychologic, and social factors that predispose them to risks of sexually transmitted diseases, including human immunodeficiency virus (HIV). This cross-sectional study, conducted between February and December 1993, recruited 165 African American women, 18-29 years of age, from an African American community of low socioeconomic status in San Francisco, California. Women completed a face-to-face interview. The prevalence of adult rape (rape experienced after age 15) in this sample was 14%. Compared with women who did not report a history of adult rape, women who reported such a history were significantly more likely to report HIV-related sexual, psychologic, and social experiences. Specifically, adult rape survivors were nearly 6 times more likely to have had sex 10 or more times in the past 3 months, 3 times as likely to report never using condoms during the past 3 months, 3.3 times less likely to use condoms consistently during the past 3 months, to have used a condom at last intercourse, and to use condoms when intoxicated, nearly 3 limes less likely to negotiate condom use, 11 times as likely to have a partner who was physically abusive, nearly 10 times more likely to believe that there were no eligible African American males with whom to establish a relationship, and more than 3 times as likely to believe that sex was unenjoyable. HIV-related social and behavioral interventions for women may be more effective if they address all sexual violence against women, including rape, and provide resources for women who are rape survivors.