Sexual violence and HIV risk behaviors among U.S. women: Is the type of sexual violence experience important?

Sexual violence, often measured by forced sex, is associated with long-term negative health and behavioral outcomes among women. Recent findings suggest that it is important to consider behaviorally-specific sexual violence measures rather than physically forced sex alone in assessing women's risk behaviors. The purpose of this study was to investigate the potential association between type of sexual violence experience and HIV risk behaviors using 2002 National Survey of Family Growth data.

In this cross-sectional study of 5,875 women ages 18 to 44 years, type of sexual violence was assessed by the following: given alcohol or drugs, told relationship would end or pressured by words, threatened with physical injury, and physically injured or held down, all at the last forced vaginal intercourse by a male. HIV risk behaviors were defined as three or more male sex partners in the past year and no condom use at last vaginal intercourse.

Of the 5,875 women, 7.6% reported three or more sex partners and 76.5% did not use a condom at last vaginal intercourse. Being told the relationship would end or pressured by words was the only type of sexual violence associated with having multiple sex partners (65.9% vs. 34.1%, p<0.05). On the other hand, being physically injured or held down, was the only type of sexual violence associated with no condom use at last sex (67.1% vs. 32.9%, p<0.05).

This population-based study suggests that it is important to consider behaviorally-specific sexual violence measures when evaluating HIV risk behaviors among women.