Intimate partner violence perpetration, standard and gendered STI/HIV risk behaviour, and STI/HIV diagnosis among a clinic-based sample of men

Abstract

Background:The estimated one in three women worldwide victimised 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.Methods: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.Results: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).Conclusions: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

The Potential of Pre-Exposure Prophylaxis for Women in Violent Relationships

“…12 In addition, the psychological sequelae of partner violence (e.g., depression, suicidal ideation) as well as substance abuse, which is associated with IPV victimization, have been shown to increase sexual risk taking and thus contribute to HIV infection. 15,16 Women's risks are compounded by the fact that perpetrators of IPV are themselves at higher risk of HIV infection, being more likely than nonperpetrators to engage in HIV risk behaviors, such as partner concurrency and transactional sex, [17][18][19] and to be diagnosed with a STI/HIV. 18,20 Violent partners are also more likely to refuse condom use.…”

“…18,20 Violent partners are also more likely to refuse condom use. 17 Gendered power inequalities place women at a disadvantage in regard to safer sex negotiation and refusal of unwanted sexual activity and thus contribute to women's increased vulnerability to the intersecting harms of IPV and HIV. Wingood and DiClemente, adapting Connell's theory of gender and power, 21 suggest that the sexual division of labor, gendered power inequalities, and social norms regarding gender, sexuality, and HIV prevention increase women's HIV risk.…”

The Association of Intimate Partner Violence, Recreational Drug Use with HIV Seroprevalence among MSM

“…Silverman et al [7] found that both physical and sexual violence from husbands increased HIV prevalence among married women. Some studies among heterosexual men, in which perpetration of IPV was the focus, showed a significant association with recent HIV/STI diagnosis [8,9]. In contrast, few studies have examined the association of IPV and HIV among men who have sex with men (MSM).…”

Factors associated with the anonymous reporting of lifetime domestic violence in a genitourinary medicine clinic: a patient self-reported questionnaire study

“…Health-care professionals need to be alerted to the risk factors, such as illicit drug use, highlighted by the study and be prepared to ask all patients, including men, about DV. 16 In this study, patients with children/dependants to care for were more likely to report lifetime DV. This could be related to the added stress to a relationship or people may be more likely to report DV for the sake of children.…”