Intimate partner violence perptration, standard and gendered STI/HIV risk behavior, and STI/HIV diagnosis among a clinic based sample of men

Harvard School of Public Health, Department of Society, Human Development and Health, Boston, Massachusetts 02115, USA.
Sexually transmitted infections (Impact Factor: 3.4). 08/2009; 85(7):555-60. DOI: 10.1136/sti.2009.036368
Source: PubMed


The estimated one in three women worldwide victimized by intimate partner violence (IPV) consistently demonstrate elevated STI/HIV prevalence, with their abusive male partners' risky sexual behaviours and subsequent infection increasingly implicated. To date, little empirical data exist to characterise the nature of men's sexual risk as it relates to both their violence perpetration, and STI/HIV infection.
Data from a cross-sectional survey of men ages 18-35 recruited from three community-based health clinics in an urban metropolitan area of the northeastern US (n = 1585) were analysed to estimate the prevalence of IPV perpetration and associations of such violent behaviour with both standard (eg, anal sex, injection drug use) and gendered (eg, coercive condom practices, sexual infidelity, transactional sex with a female partner) forms of sexual-risk behaviour, and self-reported STI/HIV diagnosis.
Approximately one-third of participants (32.7%) reported perpetrating physical or sexual violence against a female intimate partner in their lifetime; one in eight (12.4%) participants self-reported a history of STI/HIV diagnosis. Men's IPV perpetration was associated with both standard and gendered STI/HIV risk behaviours, and to STI/HIV diagnosis (OR 4.85, 95% CI 3.54 to 6.66). The association of men's IPV perpetration with STI/HIV diagnosis was partially attenuated (adjusted odds ratio (AOR) 2.55, 95% CI 1.77 to 3.67) in the multivariate model, and a subset of gendered sexual-risk behaviours were found to be independently associated with STI/HIV diagnosis-for example, coercive condom practices (AOR 1.67, 95% CI 1.04 to 2.69), sexual infidelity (AOR 2.46, 95% CI 1.65 to 3.68), and transactional sex with a female partner (AOR 2.03, 95% CI 1.36 to 3.04).
Men's perpetration of physical and sexual violence against intimate partners is common among this population. Abusive men are at increased risk for STI/HIV, with gendered forms of sexual-risk behaviour partially responsible for this association. Thus, such men likely pose an elevated infection 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 behaviours and modification of norms of masculinity that likely promote both sexual risk and violence.

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Available from: Jhumka Gupta, Jan 14, 2015
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    • "A large and growing body of literature examines patterns and trends in intimate partner violence as a phenomenon in its own right (Alhabib, Nur, and Jones 2010; Garcia-Moreno et al. 2006; Hindin, Kishor, and Ansara 2008; Kishor and Bradley 2012; Kishor and Johnson 2004), as well as the association intimate partner violence may have with broad range of health outcomes. These health outcomes include mental health and/or substance abuse (Ellsberg et al. 2008; Fals- Stewart and Kennedy 2005; González-Guarda, Florom-Smith, and Thomas 2011; Meyer, Springer, and Altice 2001), sexually transmitted infections and HIV (Barros, Schraiber, and França-Junior 2011; Campbell et al. 2008; Decker, Seage, Hemenway, Gupta, et al. 2009; Dude 2011; Jewkes et al. 2010; Kishor 2012; Raj et al. 2008; Silverman et al. 2007), and contraceptive use and other reproductive outcomes (Hindin, Kishor, and Ansara 2008; Krug et al. 2002; Speizer et al. 2009; Stephenson, Koenig, and Ahmed 2006; Swan and O'Connell 2011; Tello et al. 2008; Watts and Mayhew 2004). "
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    ABSTRACT: This study uses factor analysis of data from 12 Demographic and Health Surveys (DHS) in sub-Saharan Africa to understand the underlying structure of items related to spousal violence in the data and determine if these structures are similar or dissimilar across study countries. In spite of variation in the prevalence of the various forms of spousal violence, there is remarkable consistency in the factor structure and the item-factor structure of spousal violence. Three factors emerge in study countries: (1) emotional and physical violence, (2) sexual violence, and (3) marital control. Further analysis provides evidence that emotional and physical violence comprises two sub-factors, as does marital control. These findings generally uphold the face validity of the categories of emotional, physical, or sexual violence to which experts have previously assigned items. Our analysis provides another important insight: the six items typically categorized as marital control may represent not one, but two concepts—suspicion and isolation,—both of which are distinct from the categories of emotional, physical, or sexual violence.
    Population Association of America, Boston, MA; 05/2014
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    • "Observed differences are likely due to smaller sample size (Swenson et al. 2011). The association of HIV testing with lifetime illegal injection drug use and ever having been forced to have intercourse were also reported among young adults (Decker et al. 2009; Kellerman et al. 2002; Williams-Roberts et al. 2010). "
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    ABSTRACT: Background: Human immunodeficiency virus (HIV) remains an important public health issue and CDC recommends routine HIV screening for Americans aged 13-64. Adolescents and young adults are disproportionately affected compared to the overall population. We analyzed self-reported HIV testing and related risk behaviors at the state and national level among youths who had sexual intercourse, with a focus on state level differences. Methods: This study used the state and national Youth Risk Behaviors Surveys 2005-2011. It included a total of 59,793 national-level observations and 39,421 state-level observations of US high school students, of which respectively 28,177 and 13,916 reported ever having sexual intercourse. The outcome of interest was having ever been tested for HIV. The risk behaviors were condom use at last intercourse, number of sexual partners in lifetime, age at first intercourse, ever forced sexual intercourse, and ever illegal injection drug use. Analyses performed included logistic regression and t-test analyses. Results: HIV testing was positively associated with HIV-related risk behaviors among sexually active high school students. However, HIV testing remained relatively low (22%) between 2005 and 2011, even for those engaging in risk behaviors. Results differed among the only 7 states that monitored HIV testing through YRBS, most commonly with respect to HIV testing and condom use. Conclusions: Routine HIV testing is critical for early identification of HIV, which was set as a priority in a recent Executive Order. Our data suggest further efforts are needed to achieve widespread uptake of HIV testing among high school students. Furthermore, differences observed across states likely reflect different needs and should be followed up closely by states. Finally, having accurate data that reflects the reality of youths' lives is crucial for efficient prevention planning. Thus, more states should consider collecting HIV testing data to evaluate uptake of HIV testing among youth.
    SpringerPlus 04/2014; 3:202. DOI:10.1186/2193-1801-3-202
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    • "l during forced sex and increase exposure to STIs.53 Increased psychological distress following violence often leads to depression and substance use—known sexual risk factors.54,55 Compared to their non-abusive peers, abusive male partners are engaged in more HIV/STI risk behaviors and therefore expose their female partners to greater HIV/STI risk.56 Women with a history of abuse also are less likely to get tested for HIV.57 In terms of oppressive gender norms, gender power imbalances that favor males make it more difficult for women to negotiate safer sex and have been strongly linked to increased HIV risk through condom nonuse.50,58 For women interested in using microbicide gels, a"
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    ABSTRACT: Women and adolescent girls bear a significant burden of the global HIV pandemic. Both behavioral and biomedical prevention approaches have been shown to be effective. In order to foster the most effective combination HIV-prevention approaches for women and girls, it is imperative to understand the unique biological, social, and structural considerations that increase vulnerability to acquiring HIV within this population. The purpose of this article is to propose novel ideas for personalized biobehavioral HIV prevention for women and adolescent girls. The central argument is that we must transcend unilevel solutions for HIV prevention toward comprehensive, multilevel combination HIV prevention packages to actualize personalized biobehavioral HIV prevention. Our hope is to foster transnational dialogue among researchers, practitioners, educators, and policy makers toward the actualization of the proposed recommendations. We present a commentary organized to review biological, social, and structural factors that increase vulnerability to HIV acquisition among women and adolescent girls. The overview is followed by recommendations to curb HIV rates in the target population in a sustainable manner. The physiology of the lower female reproductive system biologically increases HIV risk among women and girls. Social (eg, intimate partner violence) and structural (eg, gender inequality) factors exacerbate this risk by increasing the likelihood of viral exposure. Our recommendations for personalized biobehavioral HIV prevention are to (1) create innovative mechanisms for personalized HIV risk-reduction assessments; (2) develop mathematical models of local epidemics; (3) prepare personalized, evidence-based combination HIV risk-reduction packages; (4) structure gender equity into society; and (5) eliminate violence (both physical and structural) against women and girls. Generalized programs and interventions may not have universal, transnational, and crosscultural implications. Personalized biobehavioral strategies are needed to comprehensively address vulnerabilities at biological, social, and structural levels.
    09/2013; 2(5):100-8. DOI:10.7453/gahmj.2013.059
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