The association between history of violence and HIV risk: a cross-sectional study of HIV-negative incarcerated women in Connecticut.
We examine the association between history of violence and risk for HIV infection among incarcerated women. Specifically, we consider physical violence and rape as they relate to unprotected sex with male primary and nonprimary (male or female) sexual partners among a sample of HIV negative female inmates (n = 1,588) housed in Connecticut's sole correctional facility for women between November 1994 and October 1996. A supplement to the mandatory Connecticut Department of Correction Inmate Medical Screening/Health History was used to collect information on each woman's background, history of violence, and unprotected sex practices. Multivariate logistic regression was used to determine the associations between violence and unprotected sex by partner type. Experiencing any violence was significantly associated with increased odds of unprotected sex with one's primary partner, even after controlling for race, history of sex work, drug use, employment status, and having other nonprimary partners. Of particular importance was having a history of physical violence. History of violence was not significantly associated with unprotected sex with nonprimary partners. These findings demonstrate the considerable vulnerability of incarcerated women to violence and suggest that this history is associated with increased unprotected sex practices, especially with male primary partners. HIV prevention interventions among women should take experiences of violence into account. Conversely, violence prevention and interventions aimed at coping with violence can be a part of the HIV prevention agenda for incarcerated women. Future longitudinal research can confirm the relationships of violence to HIV risk in women.