Sexual violence and HIV risk behaviors among a nationally representative sample of heterosexual American women: the importance of sexual coercion.
OBJECTIVE
Recent evidence suggests that it is important to consider behavioral specific sexual violence measures in assessing women's risk behaviors. This study investigated associations of history and types of sexual coercion on HIV risk behaviors in a nationally representative sample of heterosexually active American women.


METHODS
Analyses were based on 5857 women aged 18-44 participating in the 2002 National Survey of Family Growth. Types of lifetime sexual coercion included: victim given alcohol or drugs, verbally pressured, threatened with physical injury, and physically injured. Associations with HIV risk behaviors were assessed using logistic regression.


RESULTS
Of 5857 heterosexually active women, 16.4% reported multiple sex partners and 15.3% reported substance abuse. A coerced first sexual intercourse experience and coerced sex after sexual debut were independently associated with multiple sex partners and substance abuse; the highest risk was observed for women reporting a coerced first sexual intercourse experience. Among types of sexual coercion, alcohol or drug use at coerced sex was independently associated with multiple sex partners and substance abuse.


CONCLUSIONS
Our findings suggest that public health strategies are needed to address the violent components of heterosexual relationships. Future research should utilize longitudinal and qualitative research to characterize the relationship between continuums of sexual coercion and HIV risk.
Stockman
Jamila K
JK
Department of Community and Public Health, The Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA. jstockm2@son.jhmi.edu
Campbell
Jacquelyn C
JC
Celentano
David D
DD
D000293:Adolescent; D000328:Adult; D003068:Coercion; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D006801:Humans; D016015:Logistic Models; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult