A Prospective Cohort Study of Intimate Partner Violence and Unprotected Sex in HIV-Positive Female Sex Workers in Mombasa, Kenya

AIDS Behav. 2016 Sep;20(9):2054-64. doi: 10.1007/s10461-016-1399-5.


We conducted a prospective cohort study to test the hypothesis that intimate partner violence (IPV) is associated with unprotected sex in HIV-positive female sex workers in Mombasa, Kenya. Women completed monthly visits and quarterly examinations. Any IPV in the past year was defined as ≥1 act of physical, sexual, or emotional violence by the current or most recent emotional partner ('index partner'). Unprotected sex with any partner was measured by self-report and prostate specific antigen (PSA) test. Recent IPV was associated with significantly higher risk of unprotected sex (adjusted relative risk [aRR] 1.91, 95 % CI 1.32, 2.78, p = 0.001) and PSA (aRR 1.54, 95 % CI 1.17, 2.04, p = 0.002) after adjusting for age, alcohol use, and sexual violence by someone besides the index partner. Addressing IPV in comprehensive HIV programs for HIV-positive women in this key population is important to improve wellbeing and reduce risk of sexual transmission of HIV.

Keywords: Africa; Female sex workers; Intimate partner violence; Prospective study; Unprotected sex.

MeSH terms

  • Adult
  • Alcohol Drinking
  • Female
  • HIV Seropositivity / epidemiology*
  • HIV Seropositivity / psychology*
  • Humans
  • Intimate Partner Violence* / statistics & numerical data
  • Kenya / epidemiology
  • Longitudinal Studies
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Sex Offenses / psychology
  • Sex Offenses / statistics & numerical data
  • Sex Workers / psychology*
  • Sexual Behavior
  • Sexual Partners / psychology
  • Unsafe Sex / statistics & numerical data*