Partner violence is associated with STDs among female adolescents, but the mechanisms underlying this association remain unclear. Sexually coercive and deceptive behaviors of male partners that increase female STD risk may be factors in this relationship.
A sample of 356 females aged 14–20 who attended adolescent health clinics in Greater Boston between April and December 2006 were assessed for physical and sexual violence perpetrated by male partners and for exposure to sexual risk factors. Adjusted logistic regression models were used to examine the associations between intimate partner violence and standard sexual risk behaviors (e.g., multiple partnerships) and coercive or deceptive sexual risk factors (e.g., coerced condom nonuse).
More than two-fifths of the sample had experienced intimate partner violence. In adjusted analyses, adolescents reporting intimate partner violence were more likely than others to report standard sexual risk behaviors—multiple partners, anal sex and unprotected anal sex (odds ratios, 1.7–2.2). They also were more likely to report coercive or deceptive sexual risk factors—partner sexual infidelity, fear of requesting condom use, negative consequences of condom request, and coerced condom nonuse (2.9–5.3).
The high prevalence of intimate partner violence against young women attending adolescent clinics strongly indicates the need to target this population for abuse-related interventions. This need is underlined by the observed association between partner violence and sexual risk involving coercion or deception by male partners. Clinic-based STD and pregnancy prevention efforts should include assessment of sexual risk factors that are beyond the control of young women, particularly for those experiencing abuse.
Jay G. Silverman is associate professor, and Heather L. McCauley is research associate, both in the Department of Society, Human Development and Health, Harvard School of Public Health, Boston. Michele R. Decker is assistant professor, Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Baltimore. Elizabeth Miller is assistant professor, Department of Pediatrics, University of California at Davis School of Medicine. Elizabeth Reed is assistant professor, Duke Global Health Institute, Duke University, Durham, NC. Anita Raj is professor, Department of Social and Behavioral Sciences, Boston University School of Public Health.