Intimate Partner Violence and PrEP Acceptability Among Low-Income, Young Black Women: Exploring the Mediating Role of Reproductive Coercion

AIDS Behav. 2017 Aug;21(8):2261-2269. doi: 10.1007/s10461-017-1767-9.


A few studies suggest that women who experience intimate partner violence (IPV) are willing to use pre-exposure prophylaxis (PrEP), but no research has examined mediators of this relationship. The current study used path analysis to examine a phenomenon closely associated with IPV: reproductive coercion, or explicit male behaviors to promote pregnancy of a female partner without her knowledge or against her will. Birth control sabotage and pregnancy coercion-two subtypes of reproductive coercion behaviors-were examined as mediators of the relationship between IPV and PrEP acceptability among a cohort of 147 Black women 18-25 years of age recruited from community-based organizations in an urban city. IPV experiences were indirectly related to PrEP acceptability through birth control sabotage (indirect effect = 0.08; p < 0.05), but not to pregnancy coercion. Findings illustrate the importance of identifying and addressing reproductive coercion when assessing whether PrEP is clinically appropriate and a viable option to prevent HIV among women who experience IPV.

Keywords: Black/African-American women; HIV; Intimate partner violence; Pre-exposure prophylaxis; Reproductive coercion.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American*
  • Coercion*
  • Female
  • HIV Infections / prevention & control*
  • Humans
  • Intimate Partner Violence*
  • Male
  • Patient Acceptance of Health Care*
  • Poverty
  • Pre-Exposure Prophylaxis*
  • Reproduction
  • Reproductive Behavior*
  • Sexual Partners
  • Spouse Abuse
  • Surveys and Questionnaires
  • Young Adult