Kacanek, D., Bostrom, A., Montgomery, E.T., et al. Journal of Acquired Immune Deficiency Syndromes (December 2013), Vol. 64 No. 4, pp. 400-408.
The authors conducted a longitudinal study investigating the relationship between patterns of intimate partner violence (IPV) and condom and diaphragm nonadherence among 4,505 women participating in the Methods for Improving Reproductive Health in Africa study. Over half (55 percent) of women reported recent IPV, which was associated with nonadherence to using a diaphragm and condoms throughout the study. These findings imply that IPV may hinder adherence to HIV prevention interventions, including those designed to enhance women’s self-protection. Forty-one, 38, 16, and 15 percent of women reported fearing violence, emotional violence, physical assault, and forced sex, respectively, from their regular male partner. Women who reported fearing or experiencing IPV had higher odds of diaphragm nonadherence than women without such fears. Continuing forced sex was associated with condom nonadherence. Policies and interventions that specifically address IPV and related HIV risk are urgently needed, and clinical trials should include counseling and protection for women who experience IPV. It is critical to target men in IPV prevention and promote their involvement in women’s product use. Research priorities include understanding determinants of men’s perpetration of IPV and interventions targeting young men and women.