February 3, 2010
"The estimated one in three women worldwide victimized by intimate partner violence (IPV) consistently demonstrate elevated [sexually transmitted infection]/HIV prevalence, with their abusive male partners' risky sexual behaviors and subsequent infection increasingly implicated," observed the study authors. However, little empirical data exist to characterize the nature of the men's sexual risk in terms of both their violence perpetration and STI/HIV infection.
The authors estimated the prevalence of IPV perpetration and associations of such behavior with both standard (e.g., anal sex, injection drug use) and gendered (e.g., coercive condom practices, sexual infidelity, transactional sex with a female partner) forms of sexual risk behavior and self-reported STI/HIV diagnosis using data from a cross-sectional survey of men (n=1,585) ages 18-35 from three urban community-based health clinics in the Northeast.
Of participants, 32.7 percent reported perpetrating physical or sexual violence against a female intimate partner in their lifetime; one in eight (12.4 percent) self-reported a history of STI/HIV diagnosis. Men's IPV perpetration was associated with both standard and gendered STI/HIV risk behaviors, and to STI/HIV diagnosis (odds ratio 4.85, 95 percent confidence interval [CI] 3.54 to 6.66). The association of IPV perpetration with STI/HIV diagnosis was partially attenuated (adjusted odds ratio [AOR] 2.55, 95 percent CI 1.77 to 3.67) in the multivariate model, and a subset of gendered sexual risk behaviors was found to be independently associated with STI/HIV diagnosis, including coercive condom practices (AOR 1.67, 95 percent CI 1.04 to 2.69), sexual infidelity (AOR 2.46, 95 percent CI 1.65 to 3.68) and transactional sex with a female partner (AOR 2.03, 95 percent CI, 1.36 to 3.04).
"Men's perpetration of physical and sexual violence against intimate partners is common among this population," the authors concluded. "Abusive men are at increased risk for STI/HIV, with gendered forms of sexual risk behavior partially responsible for this association. Thus, such men likely pose an elevated risk to their female partners. Findings indicate the need for interwoven sexual health promotion and violence prevention efforts targeted to men; critical to such efforts may be reduction in gendered sexual risk behaviors and modification of norms of masculinity that likely promote both sexual risk and violence."
Sexually Transmitted Infections
12.2009; Vol. 85; No. 7; M.R. Decker, G.R. Seage III, D. Hemenway, J. Gupta, A. Raj, J.G. Silverman