SEXUAL VIOLENCE AGAINST WOMEN LIVING WITH OR AT RISK FOR HIV-INFECTION

Objectives: This study investigates factors associated with sexual vio lence against adult women living with and at risk for HIV infection. M ethods: Women at least 18 years old and living in Rhode island or sout heast. Massachusetts enrolled from 1987 to 1992 in a cohort study of h eterosexual HIV risk. A total of 408 women provided interviews on life time experiences of rape and HIV-related risk exposures. Data are pres ented on 96 women reporting experiences with rape as adults, and 231 w omen who reported never experiencing rape or forced sex. Results: Life time prevalence of sexual abuse was 43%. Over half occurred during adu lthood. Thirty-five percent of women with HN were raped as adults. Amo ng women with HIV, adult: rape experiences were associated with earlie r age of first sex, more sexual partners, unprotected sex involving dr ugs, earlier age of injection drug use, teen pregnancy, STDs, and seri ous gynecologic surgery than those reporting they were never raped (pr evalence odds ratios ranged from 2.8 to 11.2). Among women without HIV , adult rape was associated with similar experiences, although with so me exception, the relative odds estimates were less pronounced. Women engaged in sex work were more likely to report rape. Conclusion: The h igh prevalence of rape reported in this cohort of mostly economically poor women living with and at risk for HIV infection is consistent wit h other studies. Economic and social vulnerability that frames HIV ris k and subsequent infection in women includes rape. Clinicians caring f or women with HIV and counseling women at risk for infection need to s creen routinely for sexual abuse.