Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #122152

Michael Koenig, PhD¹, Irina Zablotska, MD, MPH¹, Tom Lutalo, Msc², Ron Gray, PhD¹, Fred Nalugoda, MHS², and Jennifer Wagman². (1) Johns Hopkins University, 615 N. Wolfe St. E4152, Baltimore, MD 21205, 410-614-4953, mkoenig@jhsph.edu, (2) UVRI Institute, P.O. Box 49, Entebbe, 256 41 32170, Uganda

Objectives: Although there is growing recognition of the potential link between coercive sex and young women's risk of HIV infection, empirical evidence on this association remains limited. We analyzed cohort data from Rakai, Uganda to investigate the association between early coercive intercourse and subsequent HIV acquisition. Methods:Using a retrospective cohort approach, we analyzed data from Rakai, Uganda for a cohort of 1996 sexually active women aged 15-24 years on the association between early coercive intercourse and subsequent risk of HIV infection. We used proportional hazards analysis to control for the effects of other socio-demographic characteristics and HIV risk behaviors. Results: 15% of study women reported that their first sexual intercourse was coercive, and an additional 16% of women reported experiencing coercion not at first intercourse, but subsequently. In the hazards analysis, young women whose first intercourse was coercive in nature were significantly more likely to subsequently acquire HIV, with risks more than twice as high as the reference group of women who reported no coercion at any time. HIV incidence among women who experienced coercion not at first sex but subsequently was not significantly higher.

Conclusions: We observed a significantly higher rate of incident HIV infection among women whose first intercourse was reported as coercive. Coercive first intercourse may provide a partial explanation for the high rates of HIV among young women in Uganda and other similar settings. Our results highlight the potential importance of addressing issues of sexual violence and coercion within current HIV prevention programs.

Learning Objectives: At the conclusion of the session, the participants will be able to

(
• Understand the potential links between early coercive sex and HIV risk for women, and (
• Recognize the importance of addressing the issues of sexual coercion and violence within current HIV prevention programs.

Presenting author's disclosure statement:

Not Answered

Recorded presentation