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Forced Sexual Initiation, Sexual Intimate Partner Violence and HIV Risk in Women: A Global Review of the Literature

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Abstract

Coerced or forced sexual initiation and sexual intimate partner violence (sexual IPV) contribute significantly to a woman’s risk for HIV infection. This review systematically examines global research (n = 21 studies) published since 2000 on the role of coerced/forced sexual initiation and sexual IPV on HIV risk in women. In predominantly low- and middle-income countries, coerced/forced sexual initiation was associated with HIV/STIs, multiple and high-risk sex partners, and no condom use. Most studies using behaviorally specific terms for sexual IPV found strong associations between sexual IPV and HIV risk behaviors. In contrast, studies using less specific definitions often failed to find these significant associations. To develop more comprehensive HIV prevention programs, future efforts should integrate behaviorally specific terms into assessing prevalence of sexual IPV and its association with HIV risk, consider cultural differences, and identify causal pathways between coerced or forced sexual initiation, HIV risk behaviors and HIV/STI infection.

Resumen

La iniciación sexual bajo coerción o forzada y la violencia sexual por una pareja íntima siguen contribuyendo significativamente al riesgo de la mujer de infectarse con el VIH. Esta revisión analiza de manera sistemática estudios realizados a nivel global (n = 21 estudios) y publicados desde el 2000 acerca del papel de la iniciación sexual bajo coerción o forzada y la violencia sexual por una pareja íntima en el riesgo que las mujeres corren de contraer el VIH. En países con ingresos mayoritariamente bajos y medios, la iniciación sexual bajo coerción o forzada estuvo relacionada con el VIH/ITS, el tener parejas sexuales tanto múltiples como de alto riesgo y la falta del uso del condón. La mayoría de los estudios que hicieron uso de términos específicos a la conducta para la violencia sexual por una pareja íntima hallaron fuertes relaciones entre la violencia sexual por una pareja íntima y los comportamientos de riesgo de contagio por el VIH. Por lo contrario, los estudios que usaron definiciones menos específicas a menudo no hallaron relaciones significativas entre la violencia sexual por una pareja íntima y el riesgo de contagio por el VIH. Para crear programas para la prevención del VIH más extensos, los futuros esfuerzos deben integrar términos específicos a la conducta en la evaluación de la prevalencia de la violencia sexual por una pareja íntima y su relación con el riesgo de contagio por el VIH, considerar las diferencias culturales e identificar las vías causales entre la iniciación sexual bajo coerción o forzada, los comportamientos de riesgo de contagio del VIH y la infección por el VIH/ITS.

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Acknowledgments

This work was supported by the National Institutes of Health (K01DA031593, L60MD003701, R25MH080664 for J.K.S. and T32HD064428 and L60MD006272 for M.B.L.). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. The authors thank Serena Ruiz for her assistance on this manuscript.

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Authors and Affiliations

  1. Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0849, La Jolla, CA, 92093-0849, USA

    Jamila K. Stockman

  2. Department of Community Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA

    Marguerite B. Lucea & Jacquelyn C. Campbell

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  1. Jamila K. Stockman
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Correspondence to Jamila K. Stockman.

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Stockman, J.K., Lucea, M.B. & Campbell, J.C. Forced Sexual Initiation, Sexual Intimate Partner Violence and HIV Risk in Women: A Global Review of the Literature. AIDS Behav 17, 832–847 (2013). https://doi.org/10.1007/s10461-012-0361-4

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