Sexual Minority Status and Violence Among HIV Infected and At-Risk Women
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Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence.
To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV.
DESIGN & PARTICIPANTS
Longitudinal study of 1,235 HIV infected and 508 uninfected women of the Women's Interagency HIV Study (WIHS) cohort, from New York City, NY, Chicago, IL, Washington D.C., and San Francisco, CA, 1994–2012.
Primary exposures are sexual identity (heterosexual, bisexual, lesbian/gay) and sexual behavior (male, female, or male & female partners). Primary outcomes are sexual abuse, intimate partner violence (IPV) and physical violence; high-risk sex and substance use were examined as mediators.
Bisexual women were at increased odds for sexual abuse [aOR 1.56 (1.00, 2.44)], IPV [aOR 1.50 (1.08, 2.09)], and physical violence [aOR 1.77 (1.33, 2.37)] compared to heterosexual women. In a separate analysis, women who reported sex with men and women (WSMW) had increased odds for sexual abuse [aOR 1.65 (0.99, 2.77], IPV [aOR 1.50 (1.09, 2.06)] and physical violence [aOR 2.24 (1.69, 2.98)] compared to women having sex only with men (WSM). Using indirect effects, multiple sex partners, cocaine and marijuana were significant mediators for most forms of abuse. Transactional sex was only a mediator for bisexual women. Women who reported sex only with women (WSW) had lower odds of sexual abuse [aOR 0.23 (0.06, 0.89)] and physical violence [aOR 0.42 (0.21, 0.85)] compared to WSM.
Women who identify as bisexual or report both male and female sex partners are most vulnerable to violence; multiple recent sex partners, transactional sex and some types of substance use mediate this relationship. Acknowledging sexual identity and behavior, while addressing substance use and high-risk sex in clinical and psychosocial settings, may help reduce violence exposure among women with and at-risk for HIV.
- Campbell JC, Baty ML, Ghandour RM, Stockman JK, Francisco L, Wagman J. The intersection of intimate partner violence against women and HIV/AIDS: a review. Int J Inj Control Saf Promot. 2008;15(4):221–31. CrossRef
- Adverse health conditions and health risk behaviors associated with intimate partner violence--United States, 2005. MMWR Morb Mortal Wkly Rep. 2008;57(5):113–7.
- Gielen AC, Ghandour RM, Burke JG, Mahoney P, McDonnell KA, O'Campo P. HIV/AIDS and intimate partner violence: intersecting women's health issues in the United States. Trauma Violence Abuse. 2007;8(2):178–98. CrossRef
- Tjaden P, Thoennes N. (NIJ & CDC). Full Report of the Prevalence, Incidence and Consequences of Violence Against Women. 2000.
- Singer M. A Dose of Drugs, A Touch of Violence, A Case of AIDS: Conceptualizing the SAVA Syndemic. Free Inq Creat Sociol. 1996;24(2):12.
- Singer M, Clair S. Syndemics and public health: reconceptualizing disease in bio-social context. Med Anthropol Q. 2003;17(4):423–41. CrossRef
- Singer M. A Dose of Drugs, A Touch of Violence, A Case of AIDS, Part 2: Further Conceptualizing the SAVA Syndemic. Free Inq Creat Sociol. 2006;34(1):16.
- Meyer JP, Springer SA, Altice FL. Substance abuse, violence, and HIV in women: a literature review of the syndemic. J Womens Health (Larchmt). 2011;20(7):991–1006. CrossRef
- El-Bassel N, Gilbert L, Wu E, Go H, Hill J. HIV and intimate partner violence among methadone-maintained women in New York City. Soc Sci Med. 2005;61(1):171–83. CrossRef
- Burke JG, Thieman LK, Gielen AC, O'Campo P, McDonnell KA. Intimate partner violence, substance use, and HIV among low-income women: taking a closer look. Violence Against Women. 2005;11(9):1140–61. CrossRef
- Cohen M, Deamant C, Barkan S, et al. Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV. Am J Public Health. 2000;90(4):560–5. CrossRef
- Stockman JK, Campbell JC, Celentano DD. Sexual violence and HIV risk behaviors among a nationally representative sample of heterosexual American women: the importance of sexual coercion. J Acquir Immune Defic Syndr. 2010;53(1):136–43. CrossRef
- Matthews DD, Blosnich JR, Farmer GW, Adams BJ. Operational Definition of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors. LGBT Health. 2013;1(1).
- IOM. (Institute of Medicine (IOM)). Lesbian Heath: Current Assessment and Directions for the Future. 1999.
- Group LGaBYSOMW. (Gay and Lesbian Medical Association). Measuring Sexual Orientation of Young People in Health Research. 2003.
- Decker MR, Wirtz AL, Baral SD, et al. Injection drug use, sexual risk, violence and STI/HIV among Moscow female sex workers. Sex Transm Infect. 2012;88(4):278–83. CrossRef
- Gilchrist G, Gruer L, Atkinson J. Comparison of drug use and psychiatric morbidity between prostitute and non-prostitute female drug users in Glasgow, Scotland. Addict Behav. 2005;30(5):1019–23. CrossRef
- Romero-Daza N, Weeks M, Singer M. "Nobody gives a damn if I live or die": violence, drugs, and street-level prostitution in inner-city Hartford, Connecticut. Med Anthropol. 2003;22(3):233–59. CrossRef
- Shannon K, Kerr T, Strathdee SA, Shoveller J, Montaner JS, Tyndall MW. Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers. BMJ. 2009;339:b2939. CrossRef
- Tyler KA. A comparison of risk factors for sexual victimization among gay, lesbian, bisexual, and heterosexual homeless young adults. Violence Vict. 2008;23(5):586–602. CrossRef
- Millay TA, Satyanarayana VA, O'Leary CC, Crecelius R, Cottler LB. Risky business: focus-group analysis of sexual behaviors, drug use and victimization among incarcerated women in St. Louis. J Urban Health. 2009;86(5):810–7. CrossRef
- Bobashev GV, Zule WA, Osilla KC, Kline TL, Wechsberg WM. Transactional sex among men and women in the south at high risk for HIV and other STIs. J Urban Health. 2009;86(Suppl 1):32–47. CrossRef
- Logan T, Leukefeld C. Sexual and drug use behaviors among female crack users: a multi-site sample. Drug Alcohol Depend. 2000;58(3):9. CrossRef
- Weber AE, Boivin JF, Blais L, Haley N, Roy E. HIV risk profile and prostitution among female street youths. J Urban Health. 2002;79(4):525–35. CrossRef
- Zule WA, Costenbader E, Coomes CM, et al. Stimulant use and sexual risk behaviors for HIV in rural North Carolina. J Rural Health. 2007;23(Suppl):6.
- Shannon K, Kerr T, Allinott S, Chettiar J, Shoveller J, Tyndall MW. Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work. Soc Sci Med. 2008;66(4):911–21. CrossRef
- Collins RL, Ellickson PL, Orlando M, Klein DJ. Isolating the nexus of substance use, violence and sexual risk for HIV infection among young adults in the United States. AIDS Behav. 2005;9(1):73–87. CrossRef
- Muzny CA, Sunesara IR, Martin DH, Mena LA. Sexually transmitted infections and risk behaviors among African American women who have sex with women: does sex with men make a difference? Sex Transm Dis. 2011;38(12):1118–25. CrossRef
- Bevier PJ, Chiasson MA, Hefferman RT, Castro KG. Women at a Sexually Transmitted Disease Clinic Who Reported Same-Sex Contact: Their HIV Seroprevalence and Risk Behaviors. Am J Public Health. 1995;85(10):6. CrossRef
- Ompad DC, Friedman SR, Hwahng SJ, Nandi V, Fuller CM, Vlahov D. HIV risk behaviors among young drug using women who have sex with women (WSWs) in New York City. Subst Use Misuse. 2011;46(2–3):274–84. CrossRef
- Scheer S, Peterson I, Page-Shafer K, et al. Sexual and Drug Use Behavior Among Women Who Have Sex With Both Women and Men: Results of a Population-Based Survey. Am J Public Health. 2002;92(7):3. CrossRef
- Teti M, Bowleg L, Rubinstein S, Lloyd L, Berhane Z, Gold M. Present But Not Accounted for: Exploring the Sexual Risk Practices and Intervention Needs of Nonheterosexually Identified Women in a Prevention Program for Women with HIV/AIDS. J LGBT Health Res. 2007;3(4):16.
- Friedman MS, Marshal MP, Guadamuz TE, et al. A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. Am J Public Health. 2011;101(8):1481–94. CrossRef
- Balsam KF, Rothblum ED, Beauchaine TP. Victimization over the life span: a comparison of lesbian, gay, bisexual, and heterosexual siblings. J Consult Clin Psychol. 2005;73(3):477–87. CrossRef
- Barkan SE, Melnick SL, Preston-Martin S, et al. The Women's Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology. 1998;9(2):117–25. CrossRef
- Bacon MC, von Wyl V, Alden C, et al. The Women's Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol. 2005;12(9):1013–9.
- NIAAA. Moderate & Binge Drinking.
- Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91. CrossRef
- Cassel DL. BootstrapMania!: Re-Sampling the SAS Way. SAS Global Forum 2010. Vol. 2013. Corvallis; 2010.
- UCLA. How can I boostrap estimates in SAS? In: Group SC, ed. Vol. 2013.
- Moyer VA, Force USPST. Screening for intimate partner violence and abuse of elderly and vulnerable adults: U.S. preventive services task force recommendation statement. Ann Intern Med. 2013;158(6):478–86. CrossRef
- HRSA. Women's Preventive Services Guideline: Affordable Care Act Expands Prevention Coverage or Women's Health and Well-Being. In: Services UDoHaH, ed.
- ACOG. (The American College of Obstetricians and Gynecologists). Well-Woman Care: Assessments & Recommendations. 2013.
- Ard KL, Makadon HJ. Addressing intimate partner violence in lesbian, gay, bisexual, and transgender patients. J Gen Intern Med. 2011;26(8):930–3. CrossRef
- Brown MJ, Groscup J. Perceptions of Same-sex Domestic Violence Among Crisis Center Staff. J Fam Violence. 2009;24:87–93. CrossRef
- Kulkin HS, Williams J, Borne HF, de la Bretonne D, Laurendine J. A review of research on violence in same-gender couples: a resource for clinicians. J Homosex. 2007;53(4):71–87. CrossRef
- Jewkes R. Intimate partner violence: the end of routine screening. Lancet. 2013;382(9888):190–1. CrossRef
- Krug E, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, eds. World report on violence and health, Ch 4: World Health Organization; 2002.
- Timko C, Valenstein H, Lin PY, Moos RH, Stuart GL, Cronkite RC. Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs. Subst Abuse Treat Prev Policy. 2012;7:37. CrossRef
- Klostermann KC. Substance abuse and intimate partner violence: treatment considerations. Subst Abuse Treat Prev Policy. 2006;1:24. CrossRef
- McClennen JC. Domestic violence between same-gender partners: recent findings and future research. J Interpers Violence. 2005;20(2):149–54. CrossRef
- Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97. CrossRef
- Young RM, Friedman SR, Case P. Exploring an HIV paradox: an ethnography of sexual minority women injectors. J Lesbian Stud. 2005;9(3):103–16. CrossRef
- Johns MM, Zimmerman M, Bauermeister JA. Sexual attraction, sexual identity, and psychosocial wellbeing in a national sample of young women during emerging adulthood. J Youth Adolesc. 2012;42(1):82–95. CrossRef
- Herrick AL, Lim SH, Plankey MW, et al. Adversity and syndemic production among men participating in the multicenter AIDS cohort study: a life-course approach. Am J Public Health. 2013;103(1):79–85. CrossRef
- Diamond LM. Female bisexuality from adolescence to adulthood: results from a 10-year longitudinal study. Dev Psychol. 2008;44(1):5–14. CrossRef
- Mock SE, Eibach RP. Stability and change in sexual orientation identity over a 10-year period in adulthood. Arch Sex Behav. 2012;41(3):641–8. CrossRef
- Kilpatrick DG, Acierno R, Resnick HS, Saunders BE, Best CL. A 2-year longitudinal analysis of the relationships between violent assault and substance use in women. J Consult Clin Psychol. 1997;65(5):834–47. CrossRef
- Ross MW, Essien EJ, Williams ML, Fernandez-Esquer ME. Concordance Between Sexual Behavior and Sexual Identity in Street Outreach Samples of Four Racial/Ethnic Groups. Sex Transm Dis. 2003;30(2):4. CrossRef
- Sexual Minority Status and Violence Among HIV Infected and At-Risk Women
Journal of General Internal Medicine
Volume 29, Issue 8 , pp 1131-1138
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- gay and lesbian health
- sexual assault
- women’s health
- Industry Sectors
- Author Affiliations
- 1. Hektoen Institute, 2225 W Harrison St, Suite B, Chicago, IL, 60612, USA
- 2. CORE Center, Cook County Bureau of Health Services, Chicago, IL, USA
- 3. SUNY Downstate Medical Center, Brooklyn, NY, USA
- 4. University of California San Francisco, San Francisco, CA, USA
- 5. Montefiore Medical Center, Bronx, NY, USA
- 6. Georgetown University Medical Center, Washington, DC, USA
- 7. Departments of Medicine, Rush University and Stroger Hospital, Chicago, IL, USA