Evidence of increased STI/HIV-related risk behavior among male perpetrators of intimate partner violence in Guatemala: results from a national survey

Abstract

Intimate partner violence (IPV) is a significant public health problem with a demonstrated link to increased sexually transmitted infection (STI)/HIV-related risk and vulnerability. While IPV is an important issue in Central America, the link to STI/HIV risk has not been explored in this region. In this study, the relationship between emotional and physical/sexual IPV and the STI/HIV-related risk behaviors of sex worker patronage and infidelity is assessed among male IPV perpetrators using data from a national survey conducted in 2009 in Guatemala (n = 4773 married/partnered men). Bivariate associations between background characteristics and emotional and physical IPV perpetration were explored. Logistic regression models were run to test associations between IPV for each sexual risk behavior. Perpetration of emotional and physical/sexual IPV was more common among married/partnered men who were older than 24, had more education, lived in urban areas, or were in common law versus married unions. Reports of past-year emotional IPV perpetration increased as wealth quintile increased. After adjusting for demographics and other characteristics, physical/sexual IPV perpetration was associated with past-year infidelity (AOR 1.9, 95% CI: 1.1-3.6). Lifetime emotional IPV (AOR 1.4, 95% CI: 1.1-1.7) and physical/sexual IPV 1.6 (95% CI 1.2-2.0) were positively associated with a history of sex worker patronage. Endorsement of traditional gender role norms showed a marginally positive association with past-year infidelity in the adjusted model (AOR 1.3, 95% CI 1.0-1.8). The study findings from Guatemala reinforce the growing evidence globally that male IPV perpetrators are more likely to engage in risky sexual behavior, including sex worker patronage and main partner infidelity. The concurrency of violence and increased STI/HIV risk may compound the health risks for female victims of IPV who also face injury and psychological trauma. Integration of prevention and screening of IPV and STI/HIV prevention services should be adopted in Guatemala and other similar contexts.

Association Between Intimate Partner Violence Against Women and HIV-Risk Behaviors

“…For example, women who had experienced physical abuse from their husband at some point in their life were two-fold more likely to have a partner who engaged in HIV risk behaviors (i.e., engaged in extra-marital sexual relationship and inconsistent condom use). This is consistent with findings from earlier studies that have found that male perpetrators of IPV engage in behavior that puts their partners at greater risk for HIV infection and transmission (Hembling & Andrinopoulos, 2014; Townsend et al, 2011). These findings suggest that those women who are aware of their partners’ risk behaviors may increase their risk of IPV while trying to negotiate safer sexual practices.…”

Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors

“…However, research is lacking in this area among women. The lack of association between IPV perpetration and HIV/STIs among women in the current study could be due to perpetration of IPV not being a significant factor in HIV risk behavior such as inconsistent condom use for women as was shown in other studies for men [109, 110]. …”

“…Research has suggested that men, who are victims of childhood sexual abuse may be more likely to show aggression and violence against others, while women may be less likely to externalize their experience in the form of aggression and may be more likely to internalize their childhood sexual abuse experiences [108]. Male perpetrators of physical and sexual IPV tend to engage in risky sexual behavior, including main partner infidelity [109], paying money for sex [109], less condom use [110], and are more likely to be diagnosed with HIV/STIs [77, 78]. This perpetration of IPV, may result from the exertion of power over partners due to feelings of powerlessness that may have been experienced during episodes of sexual abuse during childhood.…”

Perpetration of intimate partner violence among HIV positive couples: A Systematic Review

“…Intimate partner violence (IPV) is a public and social concern worldwide and comes in the forms of physical, emotional and sexual abuse. These forms of abuse are found in populations globally (Hembling andAndrinopoulos 2014, Were et al 2011). In sub-Saharan Africa, studies have reported high lifetime experience of IPV (Hembling and Andrinopoulos 2014).…”

“…These forms of abuse are found in populations globally (Hembling andAndrinopoulos 2014, Were et al 2011). In sub-Saharan Africa, studies have reported high lifetime experience of IPV (Hembling and Andrinopoulos 2014). For example, a study in South Africa revealed 32% of young males perpetrating forms of abuse against their partners as reported (Were et al 2011).…”