142nd APHA Annual Meeting and Exposition

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Verbal intimate partner violence victimization and condom/contraceptive use among African American teen women: Testing the mediating role of relationship power and depressive symptoms

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 2:45 PM - 3:00 PM

Aubrey Madkour, PhD , Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
Gretchen Clum, PhD, MA , Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Jakevia Green, MPH , Department of Epidemiology, Tulane University, New Orleans, LA
Jennifer Latimer, MPH , Department of Epidemiology, Tulane University, New Orleans, LA
Steffani Bangel, MPH , Department of Epidemiology, Tulane University, New Orleans, LA
Norine Schmidt, MPH , Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Carolyn C. Johnson, PhD , Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
Patricia Kissinger, BSN, MPH, PhD , Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Background: African American teenage women experience high rates of unintended pregnancy and STIs.  Although physical intimate partner violence victimization (IPV) has been associated with less consistent condom/contraceptive use, whether verbal victimization affects safer sex practices is understudied.

Methods: Preliminary baseline data from an unintended pregnancy prevention RCTtargeting 18-19 year old African American women were analyzed (n=224 women; n=272 relationships).  Respondents reported on sexual partnerships that occurred in the prior three months.  Verbal IPV was measured with items from the Conflict Tactics scale.  Condom and contraceptive use inconsistency were assessed with questions inquiring whether the respondent had vaginal sex with her partner without using condoms or any birth control method. Relationship power and depressive symptoms were measured using validated scales.  Controls for relationship type, childhood sex abuse, age at first intercourse, and partner concurrency were also included.  Structural equation models (SEM) were used to assess direct and mediated effects of verbal IPV on inconsistent condom and contraceptive use.

Results: Partnership-level rates of inconsistent condom use (54.5%), inconsistent contraceptive use (36.8%), and verbal victimization (54.0%) were high.  In an SEM with adequate fit (RMSEA=0.03; CFI = 0.90; TLI = 0.89), verbal IPV was directly associated with increased odds of inconsistent condom use (AOR 1.77, p<.001); mediated pathways through relationship power and depressive symptoms were non-significant.  Verbal victimization was unrelated to inconsistent contraceptive use via both direct and mediated pathways.

Conclusions: Verbal IPV is associated with condom use inconsistency.  Future analyses should explore other mechanisms by which verbal victimization affects condom use.

Learning Areas:

Epidemiology
Social and behavioral sciences

Learning Objectives:
Describe the association between verbal intimate partner violence victimization and condom/contraceptive use among African American teen women; Discuss the mediating role of relationship power and depressive symptoms for the relationship between verbal IPV and African American teen women's condom/contraceptive use.

Keyword(s): Adolescents, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting research on dating violence and sexual health among teens for nine years. I am a Co-Investigator on the RCT described in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4356.0: Exploring the intersections between violence and sexual and reproductive health