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Interpersonal violence, substance use, and HIV-related outcomes: A prospective study of impoverished women

Joan S. Tucker, PhD, Suzanne L. Wenzel, PhD, Marc N. Elliott, PhD, Grant N. Marshall, PhD, and Stephanie Williamson, BA. RAND Corporation, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407, 310-393-0411, ext. 7519, joan_tucker@rand.org

Background: Violence and substance use are significant health threats facing impoverished women and have been implicated as key risk factors for HIV in this population. This prospective study investigated whether recent partner and non-partner violence at baseline, as well as drug and alcohol misuse, predicted change in women's HIV-related behaviors and cognitions over a 6-month period.

Methods: We used structured interview data from 810 women, sampled from shelters and low-income housing in Los Angeles County, who participated in a 6-month longitudinal study.

Results: Baseline partner violence predicted declines in being sexually active (sheltered only; OR=0.39, p<.05), unprotected sex (OR=0.32, p<.01), frequency of sex (ß=-.07, p<.10) and perceived ability to refuse unwanted sex (ß=-.08, p<.10). Baseline non-partner violence predicted declines in being sexually active (housed only; OR=9.33, p<.01) and frequency of sex (ß=-.09, p<.05). Baseline drug use predicted increases in ability to refuse unwanted sex (ß = .12, p < .05) and condom use self-efficacy (ß = .13, p < .01), whereas baseline alcohol misuse predicted a decrease in ability to refuse unwanted sex (ß = -.12, p < .01) and an increase in perceived HIV susceptibility (ß = .12, p < .001)

Conclusions: These prospective findings suggest that recent experiences of violence and substance use influence women's HIV-related behaviors and cognitions in ways that are more complex than prior cross-sectional work has suggested. These changes may be the result of both changes in partner status as a result of violence and changes in sexual behaviors over time within continuing relationships.

Learning Objectives: At the conclusion of this session, attendees will be able to

Keywords: HIV/AIDS, Violence

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Women and HIV/AIDS

The 132nd Annual Meeting (November 6-10, 2004) of APHA