Sexual Coercion and Sexual Violence at First Intercourse Associated With Sexually Transmitted Infections

Background: Violence against women has been associated with subsequent risky sexual behaviors and sexually transmitted infections (STIs). We explored whether sexual coercion or violence at first intercourse was associated with self-reported STIs. Methods: Using nationally representative data from the 2006 to 2010 National Survey of Family Growth, we analyzed female respondents aged 18 to 44 (n = 9466) who answered questions on coercion at first intercourse (wantedness, voluntariness, and types of force used) and STIs using logistic regression analyses. We explored degrees of coercion, which we label as neither, sexual coercion (unwanted or nonphysical force), or sexual violence (involuntary or physical force). Results: Eighteen percent of US women reported sexual coercion, and 8.4% experienced sexual violence at first intercourse. Compared with women who experienced neither, the odds of reporting an STI was significantly greater for women who experienced sexual coercion (odds ratio, 1.27; 95% confidence interval, 1.01-1.60), after controlling for all variables. The association between sexual violence at first intercourse and STIs (odds ratio, 1.20; 95% confidence interval, 0.91-1.57) seemed to be attenuated by subsequent sexual violence. Conclusions: Understanding that women who reported a variety of coercive sexual experiences are more likely to have contracted an STI may indicate a need to focus on the broader continuum of sexual violence to fully understand the impact of even subtle forms of violence on women's health. In addition, focusing on subsequent sexual behaviors and other negative consequences remains important to improve the sexual health of women who have experienced coercive sexual intercourse.