According to the Centers for Disease Control and Prevention (CDC), approximately 15 million new cases of sexually transmitted disease (STD; now commonly called sexually transmitted infection, STI) are acquired annually. The most common STIs are chlamydia, gonorrhea, syphilis, herpes, hepatitis, genital warts, and trichomonas. STIs may have long-term implications for one’s health and may lead to many reproductive health consequences for women, such as infertility and ectopic pregnancies, while also having negative implications for an unborn fetus if experienced during a pregnancy. The best efforts to prevent the transmission of an STI are abstinence from sexual activity, monogamous relationships, and the use of latex condoms.
Sexually Transmitted Infections And Interpersonal Violence
Prevention efforts are complicated when violence is present in an intimate relationship and when sexual violence has been coerced or forced during childhood, adolescence, or the adult years. The relationship between STI transmission and interpersonal violence is an issue at all ages, for all sexual relationship types (heterosexual, homosexual, and bisexual), and among diverse racial, ethnic, and cultural communities. This relationship is a unique problem that can be explained in various ways. Most frequently, it is discussed after a sexual assault or sexual coercion (by an intimate partner, acquaintance, family member, or stranger). There is also a relationship between STIs and intimate partner violence, not only with sexual violence, but also when emotional and/or physical violence are present. STI transmission has also been related to a history of childhood sexual abuse. Issues of power and power imbalances are frequently discussed in relation to interpersonal violence. Literature suggests that those who are victims of violence—emotional, physical or sexual—despite their age are in a position that leaves them compromised to assert or negotiate for themselves, putting them at risk of various forms of violation and harm. This compromised state of power puts victims at risk of violence, which has implications for many health and mental health consequences, such as increased rates of STIs.
The CDC recommends defining sexual assault as any sexual act or contact that is forced or threatened by physical force, threats, or intimidation. Sexual assault can occur in the context of an intimate relationship and may be perpetrated by an acquaintance, a family member, or a stranger. These possibilities present an increased risk for STI transmission at the time of the assault because of the potential unknown sexual history of the assailant coupled with the probable lack of barrier protection. Sexual assault has further implications for the future psychological functioning of the victim, influencing future sexual decisions with subsequent sexual encounters that may put the victim at risk for exposure and infection of STIs.
Intimate Partner Violence
Intimate partner violence (IPV), as defined by the CDC, is physical, emotional, and sexual violence or threats of such violence and has been associated with increased STI rates and sexual practices that increase the risk of STI transmission. This association can be identified through the increased rate of violence with the negotiation of condom usage or safe sex practices. Victims of IPV express fear of engaging in the discussion of condom use or safe sex practices because of the potential for physical, sexual, or emotional violence ensuing. These factors are also magnified when alcohol and drug use are present. Alcohol and drug use has long been established as a risk factor for IPV, and the use of alcohol or drugs has important implications in the transmission of STIs. Temporal order of IPV and alcohol and/or drug use has not been well established; however, the use of either by a victim or a perpetrator can be a risk factor for violence or can be a mechanism to cope with a violent episode within a relationship. Alcohol and/or drug use can put a victim at risk by impairing the victim’s ability to consent or make good decisions regarding safe sex practices, and alcohol and/or drug use may lead to coerced or forced sexual activities. IPV has many implications for the health and welfare of those in an abusive relationship and leads to an increased risk and transmission of STIs.
Childhood Sexual Abuse
Childhood sexual abuse (CSA) has been linked to many high-risk sexual behaviors in adolescence and adulthood, such as sex with multiple partners, sex without a condom, sex while impaired by drugs or alcohol, and sex for shelter, money, or drugs. CSA is also related to experiencing or perpetrating IPV in adult relationships, suggesting a perpetual abuse cycle. The long-term psychological impact of CSA is palpable, with the negative health and wellness consequences that are evident in the research, and may lead a victim of violence to make poor decisions in adulthood that may put him or her at risk for multiple STIs that could potentially affect him or her for life.
- Heintz, A. J., & Melendez, R. M. (2006). Intimate partner violence and HIV/STD risk among lesbian, gay, bisexual and transgender individuals. Journal of Interpersonal Violence, 21, 193–208.
- Kahn, J. A., Huang, B., Rosenthal, S. L., Tissot, A. M., & Burk, R. D. (2005). Coercive sexual experiences and subsequent human papillomavirus infections and squamous intraepithelial lesions in adolescent and young adult women. Journal of Adolescent Health, 36, 363–371.
- Testa, M., Vanzile-Tamsen, C., & Livingston, J. A. (2005). Childhood sexual abuse, relationship satisfaction and sexual risk taking in a community sample of women. Journal of Consulting and Clinical Psychology, 73, 1116–1124.
- Wingood, G., & DiClemente, R. J. (1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 87, 1016–1018.
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