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Intimate partner violence perpetration, standard and gendered STI/HIV risk behaviour, and STI/HIV diagnosis among a clinic-based sample of men
  1. M R Decker1,
  2. G R Seage III2,
  3. D Hemenway3,
  4. J Gupta4,
  5. A Raj5,
  6. J G Silverman1
  1. 1
    Harvard School of Public Health, Department of Society, Human Development and Health, Boston, Massachusetts, USA
  2. 2
    Harvard School of Public Health, Department of Epidemiology, Boston, Massachusetts, USA
  3. 3
    Harvard School of Public Health, Department of Health Policy and Management, Boston, Massachusetts, USA
  4. 4
    Yale University Center for Interdisciplinary Research on AIDS, New Haven, Connecticut, USA
  5. 5
    Boston University School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts, USA
  1. Correspondence to Dr M R Decker, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; mdecker{at}


Background: The estimated one in three women worldwide victimised by intimate partner violence (IPV) consistently demonstrate elevated STI/HIV prevalence, with their abusive male partners’ risky sexual behaviours and subsequent infection increasingly implicated. To date, little empirical data exist to characterise the nature of men’s sexual risk as it relates to both their violence perpetration, and STI/HIV infection.

Methods: Data from a cross-sectional survey of men ages 18–35 recruited from three community-based health clinics in an urban metropolitan area of the northeastern US (n = 1585) were analysed to estimate the prevalence of IPV perpetration and associations of such violent behaviour with both standard (eg, anal sex, injection drug use) and gendered (eg, coercive condom practices, sexual infidelity, transactional sex with a female partner) forms of sexual-risk behaviour, and self-reported STI/HIV diagnosis.

Results: Approximately one-third of participants (32.7%) reported perpetrating physical or sexual violence against a female intimate partner in their lifetime; one in eight (12.4%) participants self-reported a history of STI/HIV diagnosis. Men’s IPV perpetration was associated with both standard and gendered STI/HIV risk behaviours, and to STI/HIV diagnosis (OR 4.85, 95% CI 3.54 to 6.66). The association of men’s IPV perpetration with STI/HIV diagnosis was partially attenuated (adjusted odds ratio (AOR) 2.55, 95% CI 1.77 to 3.67) in the multivariate model, and a subset of gendered sexual-risk behaviours were found to be independently associated with STI/HIV diagnosis—for example, coercive condom practices (AOR 1.67, 95% CI 1.04 to 2.69), sexual infidelity (AOR 2.46, 95% CI 1.65 to 3.68), and transactional sex with a female partner (AOR 2.03, 95% CI 1.36 to 3.04).

Conclusions: Men’s perpetration of physical and sexual violence against intimate partners is common among this population. Abusive men are at increased risk for STI/HIV, with gendered forms of sexual-risk behaviour partially responsible for this association. Thus, such men likely pose an elevated infection risk to their female partners. Findings indicate the need for interwoven sexual health promotion and violence prevention efforts targeted to men; critical to such efforts may be reduction in gendered sexual-risk behaviours and modification of norms of masculinity that likely promote both sexual risk and violence

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  • Funding MRD received support for analysis and manuscript development (NCIPC/CDC CE001222-01 and the Harvard University Center for AIDS Research (HU CFAR NIH/NIAID fund P30-AI060354). Support for the study that gave rise to the current analyses was provided to JGS (NCIPC/CDC 5R49CE000447-03).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Harvard School of Public Health Subjects Committee.

  • Patient consent Obtained.

  • Contributors: Study concept and design: MRD, JGS, AR; acquisition of data: MRD, JGS, JG ; analysis and interpretation of data: MRD, JGS, GRS, AR; drafting of the manuscript: MRD; critical revision of the manuscript for important intellectual content: DH, JG , AR, GRS, JGS; obtained funding: MRD, JGS; administrative, technical or other material support: JG, DH, GRS.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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