HIV this week

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

26 Oct, 2009
By: Decker M, Seage G 3rd, Hemenway D, Gupta J, Raj A, Silverman JG.

The estimated one in three women worldwide victimized by intimate partner violence consistently demonstrate elevated STI/HIV prevalence; abusive male partners’ risky sexual behaviours and subsequent infection are implicated. Little empirical data exist to characterize men’s sexual risk as it relates to violence perpetration and STI/HIV.

Data from a survey of men aged 18-35 recruited from three community-based health clinics in an urban area (n=1585) were analyzed to assess the prevalence of intimate partner violence perpetration and relations of such violent behaviour with both standard (e.g., anal sex, injection drug use) and gendered (e.g., coercive condom practices, sexual infidelity) forms of sexual risk, and STI/HIV diagnosis.

Approximately one third of participants (32.7%) reported perpetrating violence against an intimate partner in their lifetime; 1 in 8 (12.4%) participants reported history of STI/HIV diagnosis.  Men’s intimate partner violence perpetration related to both standard and gendered STI/HIV risk behaviours (AORS 1.72 to 6.22) and to STI/HIV diagnosis (OR 4.85, 95% CI 3.54, 6.66).

In a multivariate model, the association of men’s intimate partner violence perpetration with STI/HIV diagnosis was partially attenuated (AOR 2.55, 95% CI 1.77, 3.67), and a subset of gendered sexual risk behaviours were found to be independently related to STI/HIV diagnosis. Men’s perpetration of 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.

Findings indicate the need for interwoven sexual health promotion and violence prevention efforts targeted to men that include addressing gendered sexual risk.

HIV this week editors’ note:

In this cross-sectional US study of young, urban, adult men attending community health centres, a third of participants reported having perpetrated physical or sexual violence against an intimate partner. Multivariate analysis found an independent association between a history or such violence and gendered STI/HIV risk (e.g. sexual infidelity, coercive condom practices). Programmes that integrate men’s prevention of intimate partner violence into STI/HIV prevention should focus on modifying masculinity norms that support men’s entitlement to sexual control of women because these attitudes underpin both intimate partner violence and sexual risk behaviour.