%0 Journal Article %J Journal of urban health : bulletin of the New York Academy of Medicine %D 2010 %T Economic dependence and unprotected sex: the role of sexual assertiveness among young urban mothers. %A Biello, Katie Brooks %A Sipsma, Heather L %A Ickovics, Jeannette R %A Kershaw, Trace %K Adolescent %K Adult %K Assertiveness %K Economics %K Female %K Humans %K Interviews as Topic %K Mothers %K Object Attachment %K United States %K Unsafe Sex %K Urban Population %K Young Adult %N 3 %P 416-25 %R 10.1016/j.amepre.2009.08.027 %V 87 %X In the USA, sexual intercourse is the leading route of human immunodeficiency virus transmission among women, primarily through their main partner. Because male condom use is not directly under a woman's control, gender inequalities may help shape this sexual risk behavior. To examine this association, data came from follow-up interviews of young, primarily minority, pregnant women enrolled in a prospective, randomized controlled trial. Specifically, we aimed to determine the relationship between economic dependence on a male partner and condom use, and to establish whether this relationship was mediated by sexual assertiveness. Overall, 28% of women reported being economically dependent on a male partner. Young women dependent on a male partner were 1.6 times more likely to report not using a condom at last sex than women not dependent on their partner (95% confidence interval = 1.11-2.32; p = 0.01). Sexual assertiveness mediated the relationship between economic dependence and condom use (Sobel = 2.05, p = 0.04). Coupled with past research, this study supports the premise that sexual behaviors may be rooted in a complex web of social determinants. Addressing gender inequalities in contextual factors may promote healthier decisions within sexual relationships. %8 2010 May