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Diverse forms of violence may make a woman more likely to take sexual risks, according to a new study.

Researchers from The Miriam Hospital's Centers for Behavioral and Preventive Medicine say women who have experienced certain patterns of violence in both childhood and adulthood may are more likely to have risky sexual behavior, including having unprotected sex or a high number of sexual partners.

"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.

The study involved 481 women attending an urban STD clinic who were assessed for previous history of violence and current sexual risk-taking behaviors.

Subjects were primarily African American and most were socioeconomically disadvantaged. Overall, patients reported high rates of exposure to violence compared to the general population. All types of violence were interrelated, with women who experienced one type of violence being more likely to experience other forms as well.

Authors 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).

It was found that women who experienced multiple forms of violence and those who were exposed to community violence had the highest levels of sexual risk behavior, including lifetime 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," said Walsh.

She adds, "The clustering of different types of violence suggests clinicians who work with women who have experienced one type of violence should inquire about other types of violence in order to get a complete picture."

Walsh also suggests interventionists working to reduce HIV risk may want to provide women with resources for coping with intimate partner and community violence, or for overcoming childhood maltreatment or abuse. And those working with women experiencing intimate partner violence or other forms of violence may want to address strategies for safer sex.

"These findings also highlight how social and community context influence individuals in complex ways, how social and health problems often cluster, and the need to broaden risk reduction programs to include couples as well as focusing on individuals," notes Michael Carey, Ph.D., director of The Miriam Hospital's Centers for Behavioral and Preventive Medicine and a co-investigator on the study.

The findings of the study appear in the Psychology of Violence.

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