Examination of the Association Between Intimate Partner Violence and STI/HIV Risk in African American Women in High Risk Areas of Atlanta, GA: A Mixed Methods Analysis

In March 2012, President Obama issued a Presidential Memorandum creating an interagency Federal Working Group to explore the intersection of HIV/AIDS, violence against women and girls, and gender-related health disparities. Intimate partner violence (IPV) and HIV constitute major public health issues for women, particularly African American women who are disproportionately affected by HIV/AIDS. In 2012, the rate of HIV for African American women was four to 20 times higher than rates for females of other races. This study explores the complex relationship between IPV and STI/HIV risk in African American females. In an attempt to examine the intersection of IPV and STI/HIV risk this study used cross-sectional survey data to quantitatively examine the differences between women who had experienced IPV in the previous 12 months (cases) and women who had not experienced IPV in the previous 12 months (controls) in: 1) previous STI diagnosis, 2) accessing HIV testing and 3) mean scores of fear of condom negotiation due to physical violence. Chi-square analyses were completed to determine if the populations were statistically significant in terms of previous STI diagnosis and accessing HIV testing. An independent-samples t-test was conducted to compare the fear of condom negotiation scores for cases and controls. In addition, qualitative analysis was conducted to further elucidate the mechanisms from experiencing IPV to an increased risk of HIV infection. The quantitative analysis suggests a significant difference between fear of condom negotiation due to fear of physical violence. The qualitative analysis suggests that women who experience IPV are often forced to have sex with their partners, experience physical violence in response to condom negotiation and use drugs and/or alcohol to cope with the abuse. HIV prevention interventions need to address IPV as a possible risk factor. In addition, an enhancement of IPV screening in healthcare settings is needed. Future prospective studies are critical to address the issues of temporality and causality