title: Intersecting motivations for leaving abusive relationships, substance abuse, and transactional sex among HIV high-risk women.
abstract: BACKGROUND
  Women bear a significant burden of the HIV epidemic in the United States. Women classified as 'HIV high-risk' often bring co-existing histories of intimate partner violence (IPV), drug use, and transactional sex. To help inform future comprehensive HIV prevention strategies, we aimed to explore common motivating reasons and barriers to leaving and/or terminating engagement in each of these risk-promoting situations.
  
  
  METHODS
  Between August and November 2014, in-depth interviews were conducted with 14 HIV high-risk women in Atlanta, Georgia who had experienced IPV in the previous 12 months, and used drugs and/or engaged in transactional sex in the previous five years. Participants were asked about histories of IPV, drug use, and/or engagement in transactional sex, and the motivating reasons and barriers to terminating each.
  
  
  RESULTS
  Women reported a range of motivating reasons for leaving IPV, drug use, and transactional sex. Overlapping themes included impact on children, personal physical health/safety, and life dissatisfaction. Financial need was identified as a common barrier to leaving.
  
  
  CONCLUSIONS
  Future HIV prevention research should further explore the perceived impact of IPV, drug use, and transactional sex on physical health/safety, life dissatisfaction, one's children, and financial need as motivators and barriers to reducing upstream HIV risk.
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Naomi S
authors.initials: NS
authors.lastname: David
authors.affiliation: Rollins School of Public Health and Emory University School of Medicine, Emory University, Atlanta, GA.
authors.forename: Sophia A
authors.initials: SA
authors.lastname: Hussen
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Comeau
authors.affiliation: Emory University School of Medicine and Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Ameeta S
authors.initials: AS
authors.lastname: Kalokhe
keywords: HIV prevention; HIV risk; drug use; intimate partner violence; transactional sex