Forced sexual initiation, sexual intimate partner violence and HIV risk in women: a global review of the literature

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.

Figure 1

Behavioral and Physiological Mechanisms for the Relationship Between Coerced/Forced Sexual Initiation, Sexual IPV, and HIV/AIDS HPA, hypothalamic-pituitary-adrenal; STI, sexually transmitted infection; UTI, urinary tract infection.

Figure 2

Classification of forced or coerced sex

Figure 3

Identification and selection of eligible articles Authors’ Note: “Not applicable” articles included those not relevant to the review and those that did not address both sexual IPV and HIV.