AIDS and Behavior

, Volume 2, Issue 1, pp 61-73

First online:

Sexual Coercion, Physical Violence, and HIV Infection Among Women in Steady Relationships in Kigali, Rwanda

  • Ariane van der StratenAffiliated withCenter for AIDS Prevention Studies (CAPS), University of California
  • , Rachel KingAffiliated withProject San Francisco, Ministry of Health
  • , Olga GrinsteadAffiliated withCenter for AIDS Prevention Studies (CAPS), University of California
  • , Eric VittinghoffAffiliated withCenter for AIDS Prevention Studies (CAPS), University of California
  • , Antoine SerufiliraAffiliated withThe National AIDS Control Program, Ministry of Health
  • , Susan AllenAffiliated withCenter for AIDS Prevention Studies (CAPS), University of CaliforniaProject San Francisco, Ministry of HealthDivision of Clinical Epidemiology, Department of Epidemiology and Biostatistics, University of California

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The relationship between sexual coercion, physical violence, and HIV serostatus was examined at 24 months of follow-up in a cohort of 921 women with steady partners in Kigali, Rwanda. One third of the women reported sexual coercion, and physical violence perpetrated by their male partner was reported by 21%. Sexual coercion was associated with women being HIV-positive, and physical violence was associated with their partner testing HIV-positive. Independent predictors of sexual coercion included the woman being HIV-positive, refusal to have sex, condom negotiation, financial inequality, and male partner's alcohol use. Independent predictors of physical violence were similar to predictors of sexual coercion. Sexual coercion and physical violence are public health issues relevant to HIV prevention, and are associated with financial and sexual gender power differentials. Results suggest the need to expand HIV behavioral interventions to address women's economic and cultural realities.

HIV prevention women sexual coercion physical violence abuse Africa Rwanda gender roles condom negotiation