Gender based violence and psychological, relational and psychosocial outcomes that place African American women at increased risk for STIs/HIV

Background: The intersection of gender-based violence (GBV) and sexually transmitted infections (STIs) including HIV has received increased attention in public health research, especially among minority women. This study sought to recruit women who experienced GBV in the past year (cases) and compare them to women who did not experience GBV (controls) on prevalence of three STIs and a host of factors that may explain the relation between GBV and STIs/HIV.

Methods: African American women (N=110; M age=31.8; SD=11.2) were recruited from public venues, screened for GBV, and completed an audio computer-assisted interview assessing psychological, relational, psychosocial variables, and condom use behavior. Self-collected vaginal swabs were provided to test for Trichomoniasis, Chlamydia, and Gonorrhea.

Results: The sample comprised 53 cases and 57 controls. 33.6% (n=37) tested positive for one of three STIs. Multivariate analysis of variance showed a significant overall model (p=.0001); univariate F-tests suggested that increased perception of male power in the relationship, increased fear of condom negotiation, decreased self-efficacy, lower self-esteem, increased depression, greater perceived condom use barriers, less communication with sexual partners and less social support were the significant contributors. Women who experienced GBV were almost 3 times as likely to test positive for a STI, although this result was not significant (p=.14).

Conclusion: Among African American women, experiencing GBV in the past year was related to a constellation of personal, relational and psychosocial factors that may help to explain their heightened risk for STIs/HIV. Programs targeting this population must address GBV and its effects on multiple levels.