Intimate partner violence, condom use and HIV risk for adolescent girls

Adolescent girls account for a growing number of new cases of HIV in the United States, primarily transmitted through heterosexual sex. The principal method of HIV prevention for heterosexually-active girls is condom use by their male partners. Most HIV prevention interventions aimed at adolescent girls have focused on promoting the girls' individual behavior change and are most effective in situations that are under girls' control. A growing body of literature indicates the importance of recognizing partner influence on girls' condom use and negotiation strategies, and a beginning recognition of the role that intimate partner violence (IPV) may play in the decision-making control within the dyad. To better understand these linkages, this paper examines the association between IPV and girls' HIV risk through condom non-use with a systematic review of the literature and a theory-informed conceptual background. Six studies with adolescent girls were found that reported an association between intimate partner violence and increased risk for HIV (indicated by condom non-use). Gaps in the literature and implications for future research and prevention strategies are described. Findings highlight the need for more research to further elucidate the mechanisms linking intimate partner violence to condom non-use and to identify common precursors (proximal and/or distal) to explain these often co-occurring health risks. Prevention strategies that address the influence of interpersonal power dynamics and gender norms on sexual decision-making, and also incorporate ways to reduce risk for exposure to abusive relationships, hold promise for increasing effectiveness of HIV prevention interventions for adolescent girls. Such interventions need to be youth-informed and include tailored strategies for at-risk groups.