Pathways from Interpersonal Violence to Sexually Transmitted Infections: A Mixed-Method Study of Diverse Women

Objective: This research sought to delineate the pathways that link experiences of abuse in women's lives to heightened risk for sexually transmitted infections (STIs), including HIV/AIDS. It was hypothesized that ethnically diverse abused women would not only be at greater risk for STI/HIV than their nonabused counterparts but would also experience unique, abuse-related risks. Methods: In order to bridge the findings of previous studies examining abuse-generated sexual risk, this study employed a mixed-method approach that elicited data from both life-history interviews of 28 abused women and structured interviews with 215 abused and nonabused women. In the first stage of analysis, multiple coders used a combination of inductive/open and deductive/precoded text analysis to delineate patterns of sexual risks in transcripts of abused women's life histories. Next, correspondence analysis, a tool that graphically illustrates the degree of similarity or difference between variables and participants, was performed on structured interview data in order to ascertain the relationship between specific risk factors and participants' levels of abuse/affection. Logistic regression of structured data tested for the effects of ethnicity. Results: Both life-history and structured interview data revealed that a history of violence heightens STI/HIV risk in multiple interrelated ways, which include depression, substance abuse, exchange sex, first sex at an early age, high numbers of lifetime and current sexual partners, unfaithful partners, and inability to negotiate safe sex. As the severity/frequency of lifetime abuse increased, so too did sexual risk regardless of standard sociodemographic factors or ethnicity of participants. Conclusions: The domestic violence literature indicates an association between violence and STI/HIV risk. Findings from this mixed-method research provide a detailed account of the pathways that link the two.