Abstract
This paper examines the association between intimate partner violence and the consistency of condom use in a US urban cohort of HIV-serodiscordant couples. It uses both male and female data from the California Partners Study II of a lower-income ethnically mixed cohort of 145 such couples in the San Francisco Bay Area. We observed a significant association between inconsistent condom use and physical abuse and forced sex: the risk of inconsistent condom use was double for those experiencing physical abuse (OR, 2.2; 95%CI, 1.1, 4.1). Injection drug use and a history of bisexual behavior were also associated with inconsistent condom use. Physical abuse tended to be reciprocal between partners (OR, 3.2; 95% CI, 1.9, 5.6). Our findings suggest that interventions effective in reducing intimate partner violence, and/or reducing the use of injection drugs in HIV-serodiscordant couples could lead to less transmission of HIV.
Highlights
Heterosexual transmission of Human Immunodeficiency Virus (HIV) has steadily increased in the United States since the start of the epidemic
Our findings suggest that interventions effective in reducing intimate partner violence, and/or reducing the use of injection drugs in HIV-serodiscordant couples could lead to less transmission of HIV
The association of Intimate Partner Violence (IPV) with inconsistent condom use remains a significant problem with implications for further research as well as for prevention development
Summary
Heterosexual transmission of Human Immunodeficiency Virus (HIV) has steadily increased in the United States since the start of the epidemic. More HIV-serodiscordant heterosexual relationships are likely to exist in the United States, for whom the importance of practicing safer sex is critical. Consistent condom use is a key component of practicing safer sex in such relationships [1,2,3,4]. One factor influencing safer sex practices in general, and condom use in particular, is Intimate Partner Violence (IPV). One form of IPV, physical violence, has been associated with the practice of unsafe sex, a primary component of which is lack of condom use [7,8,9,10,11,12,13,14,15]. IPV has been considered both a precursor and a sequela of HIV [16]
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