Exposure to Different Types of Violence and Subsequent Sexual Risk Behavior Among Female Sexually Transmitted Disease Clinic Patients: A Latent Class Analysis

Objective: Diverse forms of violence, including childhood maltreatment (CM), intimate partner violence, and exposure to community violence (ECV), have been linked separately with sexual risk behaviors. However, few studies have explored multiple experiences of violence simultaneously in relation to sexual risk-taking, especially in women who are most vulnerable to violent experiences. Method: Participants were 481 women (66% African American, M-age = 27 years) attending a publicly funded sexually transmitted disease (STD) clinic who reported on their past and current experiences with violence and their current sexual risk behavior. We identified patterns of experience with violence using latent class analysis and investigated which combinations of experiences were associated with the riskiest sexual outcomes. Results: Four classes of women with different experiences of violence were identified: low violence (39%), predominantly ECV (20%), predominantly CM (23%), and multiply victimized (18%). Women in the multiply victimized and predominantly ECV classes reported the highest levels of sexual risk behavior, including more lifetime sexual partners and a greater likelihood of receiving STD treatment and using substances before sex. Conclusion: Women with different patterns of violent experiences differed in their sexual risk behavior. Interventions to reduce sexual risk should address violence against women, focusing on experiences with multiple types of violence and experiences with ECV specifically. Additional research is needed to determine the best ways to address violence in sexual risk reduction interventions.