Women who have experienced several forms of violence, from witnessing neighborhood crimes to being abused themselves, are more likely to engage in risky sexual behaviors, such as having unprotected sex or a high number of sexual partners, according to a new study.
“Sadly, our results show that many women must cope with multiple forms of violence, and that some combinations of violent experiences put women at risk for HIV, other STDs or unplanned pregnancy, not to mention the risks from the violence itself,” said lead author Jennifer Walsh, Ph.D., of The Miriam Hospital’s Centers for Behavioral and Preventive Medicine.
Although previous research has linked sexually risky behavior and diverse forms of violence, such as childhood maltreatment and sexual abuse, domestic abuse, and exposure to community violence, very few studies have considered patterns of violence and their impact on sexual risk-taking, according to the researchers.
The study included 481 women attending an urban STD clinic who were assessed for a previous history of violence and sexually risky behaviors. The women were primarily African-American and most were poor.
Overall, these women reported high rates of exposure to violence compared to the general population. All types of violence were interrelated, with women who experienced one type being more likely to experience other forms as well, the researcher noted.
Using a statistical technique known as latent class analysis to find common patterns in the data, researchers identified four classes of women with different experiences of violence: Women with low exposure to violence (39 percent); women who were predominantly exposed to community violence (20 percent); women who were predominantly exposed to childhood maltreatment (23 percent); and women who experienced multiple forms of violence (18 percent).
The team found that the women who reported experiencing multiple forms of violence and those who were exposed to community violence had the highest levels of risky behavior, including a higher number of sexual partners and alcohol and drug use before sex.
“Given the ties between multiple violent experiences and sexual risk-taking, clinicians working with women who experience violence or who are at risk for HIV/STDs may need to consider the overlap between the two in order to impact sexual health consequences,” Walsh said
Those who work with women who have experienced one type of violence should ask about other types of violence “to get a complete picture.”
The researcher adds further research is needed to understand how and why violent experiences are associated with sexually risky behavior to help develop more effective interventions.