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

Abstract #113021

Elizabeth Miller, MD, PhD, Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital, 50 Staniford St., 9th Floor, Boston, MA 02114, 781-485-6350, emiller1@partners.org, Michele R. Decker, MPH, Division of Public Health Practice/Department of Society, Human Development & Health, Harvard University, 677 Huntington Ave., Kresge 705, Boston, MA 02115, Jeanne E. Hathaway, MD, MPH, Division of Pubic Health Practice, Harvard School of Public Health, 677 Huntington Ave., Kresge 705, Boston, MA 02115, Elizabeth Reed, MPH, Violence Prevention and Intervention Services, Massachusetts Department of Public Health, 250 Washington Street, 4th floor, Boston, MA 02108, Anita Raj, PhD, Department of Social and Behavioral Sciences, Boston University School of Public Health, 715 Albany St, T2W, Boston, MA 02118, Ruth Paris, MSW, PhD, School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215, and Jay G. Silverman, PhD, Department of Health and Social Behavior/Division of Public Health Practice, Harvard School of Public Health, 1552 Tremont St, Boston, MA 02120.

Background: Adolescent intimate partner violence (IPV) is closely associated with behaviors that put teens at risk for HIV, other STIs, and pregnancy, but potential mechanisms for this association have not been clearly elucidated (1,2). Methods: A convenience sample of fifty adolescent girls, referred by health care providers and DV advocates for an IPV history, completed a health survey and 60 minute open-ended narrative interview about their experiences in abusive relationships, with a focus on sexual and contraceptive practices. The interviews were also coded for multiple contextual factors including education, family violence, pregnancy, and substance use. Results: Condom nonuse is common in the context of IPV. Patterns include erratic condom use, condom refusal, condom manipulation (taking off during intercourse, poking holes), condom attrition (initial use, followed shortly by consistent nonuse), and absence of condoms (no discussion, girls' fears about asking). These experiences vary between girls who have not been pregnant versus those pregnant and parenting. Conclusions: Condom nonuse occurs in the context of power and control in an abusive relationship and these patterns underscore the need to include relationship violence discussions in the context of teen sexual health education. References:(1) Silverman J, Raj A, Mucci L and Hathaway J. Dating Violence Against Adolescent Girls and Associated Substance Use, Unhealthy Weight Control, Sexual Risk Behavior, Pregnancy, and Suicidality. JAMA 2001;286(5):572-578. (2) Silverman JG, Raj A, Clements K. Dating Violence and Associated Sexual Risk and Pregnancy Among Adolescent Girls in the United States. Pediatrics 2004;114:e220-225.

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