Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, , Baltimore, Maryland, USA.
Sex Transm Infect. 2014 Mar;90(2):145-9. doi: 10.1136/sextrans-2013-051288. Epub 2013 Nov 14.
BACKGROUND/OBJECTIVES: Adolescent and young adult women are at high risk for sexually transmitted infections (STIs)/HIV and intimate partner violence (IPV). We evaluate the prevalence of IPV in the past 3 months and its associations with STI/HIV risk, STI and related care-seeking over the same time period.
Female family planning clinic patients ages 16-29 years (n=3504) participated in a cross-sectional survey in 2011-2012 as a baseline assessment for an intervention study. We examined associations of recent IPV with sexual and drug-related STI/HIV risk behaviour, self-reported STI and STI-related clinical care seeking via logistic regression.
Recent physical or sexual IPV (prevalence 11%) was associated with recent sexual and drug-related STI/HIV risk, specifically unprotected vaginal sex (adjusted OR (AOR) 1.93, 95% CI 1.52 to 2.44), unprotected anal sex (AOR 2.22, 95% CI 1.51 to 3.27) and injection drug use, their own (AOR 3.39, 95% CI 1.47 to 7.79) and their partner's (AOR 3.85, 1.91 to 7.75). IPV was also linked with coercive sexual risk: involuntary condom non-use (AOR 1.87 to 95% CI 1.51 to 2.33), and fears of requesting condoms (AOR 4.15, 95% CI 2.73 to 6.30) and refusing sex (AOR 11.84, 95% CI 7.59 to 18.45). STI-related care-seeking was also more common among those abused (AOR 2.49, 95% CI 1.87 to 3.31).
Recent IPV is concurrent with sexual and drug-related STI/HIV risk, including coercive sexual risk, thus compromising women's agency in STI/HIV risk reduction. Clinical risk assessments should broaden to include unprotected heterosexual anal sex, coercive sexual risk and IPV, and should promote safety and harm reduction.
背景/目的：青少年和年轻成年女性感染性传播疾病（STIs）/艾滋病毒和亲密伴侣暴力（IPV）的风险很高。我们评估了过去 3 个月内 IPV 的流行率及其与同期 STI/HIV 风险、STI 和相关护理寻求的关联。
2011-2012 年，3504 名年龄在 16-29 岁的计划生育诊所女性患者参与了一项横断面调查，作为干预研究的基线评估。我们通过逻辑回归检查了最近的 IPV 与性和药物相关的 STI/HIV 风险行为、自我报告的 STI 和 STI 相关临床护理寻求之间的关联。
最近的身体或性 IPV（患病率 11%）与近期性和药物相关的 STI/HIV 风险相关，具体包括无保护的阴道性交（调整后的比值比（AOR）为 1.93，95%置信区间（CI）为 1.52 至 2.44）、无保护的肛交（AOR 为 2.22，95%CI 为 1.51 至 3.27）和注射毒品，他们自己的（AOR 为 3.39，95%CI 为 1.47 至 7.79）和他们伴侣的（AOR 为 3.85，95%CI 为 1.91 至 7.75）。IPV 也与强制性性风险有关：非自愿使用避孕套（AOR 为 1.87 至 95%CI 为 1.51 至 2.33），以及害怕要求避孕套（AOR 为 4.15，95%CI 为 2.73 至 6.30）和拒绝性行为（AOR 为 11.84，95%CI 为 7.59 至 18.45）。在遭受虐待的人中，寻求与性传播疾病相关的护理也更为常见（AOR 为 2.49，95%CI 为 1.87 至 3.31）。
最近的 IPV 与性和药物相关的 STI/HIV 风险同时发生，包括强制性性风险，从而损害了女性在降低 STI/HIV 风险方面的代理权。临床风险评估应扩大到包括无保护的异性肛交、强制性性风险和 IPV，并应促进安全和减少伤害。
