The study included women seen at an upstate New York public clinic that treats people with sexually transmitted diseases. The women completed a questionnaire that asked them about intimate relationships and risky sexual behaviour.
17% of the women reported domestic violence in the past three months. And recent domestic violence was associated with a fear that asking a male partner to use a condom during sex would lead to violence.
"Our findings suggest that women involved in violent relationships fear that their partner might respond with violence if asked to use a condom, which in turn leads to less condom use for these women," Theresa Senn, a senior research scientist at the Centres for Behavioural and Preventive Medicine at Miriam Hospital in Providence, Rhode Island, said in a hospital news release.
"Protecting themselves from unwanted pregnancy and sexually transmitted infections, including HIV, is not as easy as just telling their partner to wear a condom," said Senn, the study's co-author. "The potential consequences of asking their partner to wear a condom are more immediate and potentially more severe than an unintended pregnancy or sexually transmitted infection."
Threat of domestic violence
The findings, published online recently in the journal Women & Health, show that health care providers involved in preventing HIV, the virus that causes Aids, and other sexually transmitted infections need to help women deal with the threat of domestic violence, Senn said.
"For women in violent relationships, counselling to use a condom and training in condom assertiveness skills are unlikely to increase condom usage," Senn said. These women might need additional counselling about healthy relationships, and assistance developing a safety plan, she said.
Each year, 27% of new HIV infections in the United States are in women, and heterosexual sex accounts for 83% of those infections, according to the news release. A recent national study found that 12% of HIV infections among women were linked with domestic violence.