AIDS and Behavior

, Volume 21, Issue 8, pp 2261–2269 | Cite as

Intimate Partner Violence and PrEP Acceptability Among Low-Income, Young Black Women: Exploring the Mediating Role of Reproductive Coercion

  • Tiara Willie
  • Trace Kershaw
  • Jacquelyn C. Campbell
  • Kamila A. Alexander
Original Paper


A few studies suggest that women who experience intimate partner violence (IPV) are willing to use pre-exposure prophylaxis (PrEP), but no research has examined mediators of this relationship. The current study used path analysis to examine a phenomenon closely associated with IPV: reproductive coercion, or explicit male behaviors to promote pregnancy of a female partner without her knowledge or against her will. Birth control sabotage and pregnancy coercion—two subtypes of reproductive coercion behaviors—were examined as mediators of the relationship between IPV and PrEP acceptability among a cohort of 147 Black women 18–25 years of age recruited from community-based organizations in an urban city. IPV experiences were indirectly related to PrEP acceptability through birth control sabotage (indirect effect = 0.08; p < 0.05), but not to pregnancy coercion. Findings illustrate the importance of identifying and addressing reproductive coercion when assessing whether PrEP is clinically appropriate and a viable option to prevent HIV among women who experience IPV.


Intimate partner violence Reproductive coercion HIV Pre-exposure prophylaxis Black/African-American women 


Algunos estudios sugieren que las mujeres que experimentan violencia de pareja están dispuestas a usar la profilaxis previa a la exposición (PrEP), pero ninguna investigación ha examinado a los mediadores de esta relación. El presente estudio utilizó el análisis de trayectoria para examinar un fenómeno estrechamente asociado con el IPV: coerción reproductiva o comportamientos masculinos explícitos para promover el embarazo de una pareja sin su conocimiento o contra su voluntad. El control del control de la natalidad y la coerción del embarazo -dos subtipos de conductas de coerción reproductiva- fueron examinados como mediadores de la relación entre la aceptación de la violencia de pareja y PrEP en una cohorte de 147 mujeres negras de 18 a 25 años reclutadas de organizaciones comunitarias en una ciudad urbana. Las experiencias de IPV se relacionaron indirectamente con la aceptación de la PrEP a través del sabotaje de control de la natalidad (efecto indirecto = 0,08; p < 0,05), pero no a la coerción del embarazo. Los hallazgos ilustran la importancia de identificar y abordar la coerción reproductiva al evaluar si la PrEP es clínicamente apropiada y una opción viable para prevenir el VIH entre las mujeres que experimentan violencia de pareja.



The research was supported by grants from the National Institute of Mental Health (R25-MH087217 and T32MH020031) and Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32-HDO64428).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review boards and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Tiara Willie
    • 1
    • 2
  • Trace Kershaw
    • 1
    • 2
  • Jacquelyn C. Campbell
    • 3
  • Kamila A. Alexander
    • 1
    • 3
    • 4
  1. 1.Center for Interdisciplinary Research on AIDSYale UniversityNew HavenUSA
  2. 2.Division of Social and Behavioral SciencesYale School of Public HealthNew HavenUSA
  3. 3.Department of Community Public Health NursingJohns Hopkins School of NursingBaltimoreUSA
  4. 4.Johns Hopkins School of NursingBaltimoreUSA

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