Victims of intimate partner violence have an elevated likelihood of engaging in risky sexual behaviors, and one such behavior—whose prevalence is on the rise—is anal intercourse. So, are the experiences of intimate partner violence and anal sex related? Kristen L. Hess and colleagues address this question in this issue of Perspectives on Sexual and Reproductive Health, using data on heterosexual relationships reported by young adult participants in the National Longitudinal Study of Adolescent Health. Among the findings are that the likelihood of anal sex was greater in relationships in which the woman or both partners perpetrated physical abuse than in nonviolent relationships, although not in ones in which the woman was a victim but not a perpetrator. What is more, within relationships that included anal sex, the odds of condom use during anal sex were reduced if the woman was the victim of physical abuse. Relationships in which one partner or the other perpetrated sexual violence also were marked by heightened odds of including anal sex, but condom use was not associated with reports of sexual violence.
Hess and coauthors stress that it is difficult to interpret these associations without information about the context of abuse—particularly, whether it preceded or followed anal sex—and that they cannot assess whether the violence and anal sex were directly related. Event‐level and qualitative studies, they suggest, could yield a "more complete picture of … the context within which [anal sex] occurs, they suggest. A clearer understanding of the associations suggested in these analyses would help determine whether interventions aimed at reducing violence within relationships might also be effective at lowering sexual risk.
Also in This Issue
•To reduce the health toll of abortion complications—and decrease the incidence of abortion—it is vital to help women avoid unwanted pregnancies. Information that sheds light on the subgroups of women most likely to have an unintended pregnancy is generally available only in countries in which abortion is legal or not highly restricted; age is the most commonly recorded characteristic. Using data from more than 40 countries where legal abortion is generally available, Gilda Sedgh and colleagues calculated age‐specific abortion rates and percentage distributions of abortions by age, taking into account the estimated completeness of reporting. Drawing on information on contraceptive use and unmet need in the countries studied, the authors speculate that higher abortion rates in particular age‐groups probably reflect above‐average levels of unmet need for contraception or difficulty in using methods effectively, as well as a stronger desire to avoid childbearing.
•Not only women's pregnancy intentions, but also their perceptions of the benefits of childbearing, may influence their sexual behavior and pregnancy risk, as Corrine H. Rocca, Cynthia C. Harper and Tina R. Raine‐Bennett report. The researchers developed a scale to assess perceived benefits of motherhood and administered it to a clinic‐based sample of women who were initiating use of a hormonal contraceptive and did not wish to become pregnant in the next year. Scale scores were positively associated with the likelihood of pregnancy during a 12‐month follow‐up period, but were unrelated to contraceptive discontinuation. Rocca and colleagues speculate that even when women do not wish to become pregnant, they may stop using contraceptives more for reasons related to the methods than because of their attitudes toward childbearing.
•A study described by Arik V. Marcell and coauthors demonstrated that a brief risk reduction intervention may benefit out‐of‐school male youth, who have been largely overlooked in targeted interventions. The program, aimed at a predominantly black population receiving services at a youth employment and training center, was an adaptation of one that had previously been successful among Latinos. Its three sessions provided information about STDs, condom use, clinical care and community sources of services. Findings from a three‐month follow‐up survey suggest that participants had greater knowledge about STDs and health care services, engaged in some safer‐sex behaviors more often and sought STD‐related care more frequently than controls. Although the study did not assess some variables that the authors acknowledge may have affected the results, the researchers conclude that it "highlights the promise of a limited and relatively inexpensive intervention" for community‐based programs serving groups that engage in high‐risk behaviors.
•As a step toward understanding why blacks and Hispanics have higher levels of unintended fertility than whites, Sarah R. Hayford and Karen Benjamin Guzzo examine two aspects of motivation to avoid pregnancy. In analyses of data from a nationwide survey, they find that the extent to which unmarried young adults consider it important to avoid pregnancy does not differ among racial and ethnic groups. The extent to which young men and women would be upset by an unintended pregnancy does, but not necessarily in expected ways: Foreign‐born Hispanics were less likely than whites, but blacks were more so, to say that they would be upset if they experienced an unintended pregnancy. Therefore, the authors suggest, motivation to avoid pregnancy "deserves further attention" as a possible factor in Hispanics’ relatively high levels of unintended childbearing, but future work should explore other potential explanations for black‐white differences.
—The Editors