Reproductive coercion, sexual risk behaviours and mental health symptoms among young low-income behaviourally bisexual women: implications for nursing practice.

Abstract

To describe prevalence of reproductive coercion, sexual risk behaviours and mental health symptoms among women reporting lifetime sexual experiences with men and women compared to peers reporting sex exclusively with men. Reproductive coercion, a global public health problem, is understudied among sexual minority women. Violence against women remains high among women who have sex with women and men. Rates of sexual and physical violence among this population are higher than women reporting exclusive sexual partnerships with either men or women. Nurses and other healthcare providers often do not conduct comprehensive sexual histories; assumptions related to a sex partner's gender may provide indications of broader health implications. Cross-sectional survey of low-income Black women ages 18-25 recruited from six community-based sites for a parent study focused on intimate partner violence and health. We analysed survey data from participants who reported lifetime sexual experiences with men and women (N=42) and compared their outcomes to those of women reporting sexual experiences with men only (N=107). A greater proportion of women who have sex with women and men reported experiencing reproductive coercion. Women who have sex with women and men also reported a greater number of lifetime intimate partner physical and sexual violence experiences, traded sex for resources, and had post-traumatic stress disorder symptoms. Findings provide vital information that can inform nursing clinical practice, specifically related to history-taking, screening protocols and counselling strategies for intimate partner violence and mental health among women who have sex with women and men. Strategies for addressing reproductive coercion and intimate partner violence as well as the health consequences among women who have sex with women and men in clinical and community-based settings should include a longitudinal understanding of sexual behaviour and gender of sex partners.