title: Coercive sex in rural Uganda: prevalence and associated risk factors.
abstract: Despite growing recognition of the problem, relatively little is known about the issue of coercive sex in developing countries. This study presents findings from a community-based survey of 4279 reproductive-aged women in current partnerships in the Rakai District of Uganda carried out in 1998-99. One in four women in our study report having experienced coercive sex with their current male partner, with most women reporting its occasional occurrence. In a regression analysis of risk factors for coercive sex, conventional socio-demographic characteristics emerged as largely unpredictive of the risk of coercive sex. Behavioral risk factors-most notably, younger age of women at first intercourse and alcohol consumption before sex by the male partner-were strongly and positively related to the risk of coercive sex. Coercive sex was also strongly related to perceptions of the male partner's HIV risk, with women who perceived their partner to be at highest risk experiencing almost three times the risk of coercive sex relative to low risk partnerships. Supplemental analysis of 1-year longitudinal data provides additional support for the hypothesis that coercive sex may frequently be a consequence of women's perceptions of increased HIV risk for their male partner. The findings of this study are discussed in terms of the need for sexual violence prevention programs more generally in settings such as Uganda, and in terms of the possible importance of incorporating issues of sexual and physical violence within current HIV prevention programs.
authors.affiliation: Department of Population and Family Health Sciences, Bloomberg School of Public Health, The Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA. mkoenig@jhsph.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Koenig
authors.forename: Tom
authors.initials: T
authors.lastname: Lutalo
authors.forename: Feng
authors.initials: F
authors.lastname: Zhao
authors.forename: Fred
authors.initials: F
authors.lastname: Nalugoda
authors.forename: Noah
authors.initials: N
authors.lastname: Kiwanuka
authors.forename: Fred
authors.initials: F
authors.lastname: Wabwire-Mangen
authors.forename: Godfrey
authors.initials: G
authors.lastname: Kigozi
authors.forename: Nelson
authors.initials: N
authors.lastname: Sewankambo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wagman
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Maria
authors.initials: M
authors.lastname: Wawer
authors.forename: Ron
authors.initials: R
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D003068:Coercion; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012423:Rural Health / Q000706:statistics & numerical data; D012742:Sex Offenses / Q000517:prevention & control / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000523:psychology; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D014454:Uganda / Q000453:epidemiology