Early View

Intimate Partner Violence, Sexual Autonomy and Postpartum STD Prevention Among Young Couples: A Mediation Analysis

CONTEXT

The transition to parenthood is a stressful time for young couples and can put them at risk for acquiring STDs. Mechanisms underlying this risk—particularly, intimate partner violence (IPV) and sexual autonomy—have not been well studied.

METHODS

Between 2007 and 2011, a prospective cohort study of the relationships and health of pregnant adolescents and their male partners recruited 296 couples at four hospital-based obstetrics and gynecology clinics in the U.S. Northeast; participants were followed up six and 12 months after the birth. Structural equation modeling identified associations among IPV at baseline and six months, sexual autonomy at six months and STD acquisition at 12 months. Mediating effects of sexual autonomy were tested via bootstrapping.

RESULTS

Females were aged 14–21, and male partners were 14 or older. For females, IPV victimization at baseline was positively associated with the likelihood of acquiring a postpartum STD (coefficient, 0.4); level of sexual autonomy was inversely associated with the likelihood of acquiring an STD and of having a male partner who acquired one by the 12-month follow-up (–0.4 for each). For males, IPV victimization at baseline was negatively correlated with a female partner's sexual autonomy (–0.3) and likelihood of acquiring an STD (–0.7); victimization at six months was positively related to a partner's sexual autonomy (0.2). Sexual autonomy did not mediate these relationships.

CONCLUSIONS

Females' sexual autonomy appears to protect against postpartum STDs for both partners. Future research should explore the efficacy of IPV-informed approaches to improving women's sexual and reproductive health.

Authors' Affiliations

Tiara C. Willie is a Ph.D. candidate, Department of Chronic Disease Epidemiology, Yale School of Public Health, and a pre-doctoral fellow, Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT. Tamora A. Callands is assistant professor, Department of Health Promotion and Behavior, University of Georgia, Athens. Trace S. Kershaw is professor and chair, Department of Social and Behavioral Sciences, Yale School of Public Health, and director, Interdisciplinary Research Methods Core, Center for Interdisciplinary Research on AIDS.

Disclaimer
The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.

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