Assessing the contribution of perpetration of intimate partner violence to heterosexual men's sexual HIV risk behavior

Background: Research has documented the relationship between intimate partner violence victimization and sexual HIV acquisition risk behaviors, such as inconsistent condom use, among heterosexual women. There is less research on the role of perpetration of intimate partner violence in sexual HIV transmission risk behavior among heterosexual men. Existing studies of this relationship have generally not examined condom use-related and other factors associated with high risk behavior, such as outcome expectancies or partner desire for pregnancy. Methods: Using data from structured interviews with 307 heterosexual men recruited via street-intercept methods between 2005 and 2006 in 36 New York City neighborhoods, we assessed the relationship between perpetration of intimate partner violence against a main female partner and inconsistent condom use with that same partner, while controlling for condom use-related and other factors, such as condom use barriers, outcome expectancies and relationship dominance. Results: Nearly a third of men surveyed reported using moderate physical violence and 5% reported using sexual violence against their main female partners. Multivariate logistic regression revealed that men who perpetrated intimate partner physical violence were 60% less likely to report consistent condom use as compared with men who did not use violence, while controlling for sociodemographic, condom use-related and other factors identified as significantly associated with the outcome in bivariate analyses. Conclusions: Intimate partner violence perpetration by heterosexual men makes a unique contribution to sexual HIV transmission risk behaviors. Given the growing heterosexual HIV epidemic, interventions that simultaneously address men's sexual HIV risk behaviors and partner violence are suggested.