title: HIV risk behaviors and the context of sexual coercion in young adults' sexual interactions: results from a diary study in rural South Africa.
abstract: BACKGROUND
  Gender inequalities in relationship power may promote unprotected sexual intercourse.
  
  
  OBJECTIVE
  The goal of this study was to gain insight into the specific gender dynamics in the intimate relationships of rural South African young adults that contribute to risk for HIV infection.
  
  
  METHODS
  Using diary methods, 25 female and 25 male secondary school students in rural South Africa provided daily reports (N = 1000) over a 3-week timeframe, including details regarding 466 sexual interactions.
  
  
  RESULTS
  Inconsistent condom use was more likely in relationships in which the male partner had ever used threat or force to engage in sex during this period (unadjusted odds ratio, 13.4; 95% confidence interval, 1.57-114.26). Male sexual coercion was more likely in relationships in which alcohol was ever used in conjunction with sex and when a man's desire to engage in sex was perceived as greater than the woman's.
  
  
  CONCLUSIONS
  This study adds to the growing evidence that sexual relationships characterized by gender inequality and sexual coercion are contexts of sexual risk.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA. hoffman@pi.cpmc.columbia.edu
authors.forename: S
authors.initials: S
authors.lastname: Hoffman
authors.forename: L F
authors.initials: LF
authors.lastname: O'Sullivan
authors.forename: A
authors.initials: A
authors.lastname: Harrison
authors.forename: C
authors.initials: C
authors.lastname: Dolezal
authors.forename: A
authors.initials: A
authors.lastname: Monroe-Wise
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008499:Medical Records; D012309:Risk-Taking; D012424:Rural Population; D012725:Sexual Behavior; D012747:Sexual Partners; D013019:South Africa