A qaualitative descriptive study of women's sexual health in the context of intimate partner violence

Female survivors of intimate partner violence (IPV) are at increased risk for negative sexual health outcomes, such as susceptibility to HIV/AIDS, other sexually transmitted infections, unintended pregnancy, miscarriage, and cervical cancer. Despite this known risk, HIV risk reduction interventions are lacking in IPV content, and little is known about women’s protective sexual health behaviors in this context. The purpose of this dissertation is to gain a deeper understanding of women’s sexual health within the context of a violent intimate relationship. Data were collected through semi-structured, in-person interviews with women who had experienced IPV (N = 28). Service-seeking women were recruited from a domestic violence shelter and a domestic violence counseling program; non-service-seeking women were recruited through a statewide coalition against domestic violence and online advertisements. Interviews were audio-recorded, transcribed, and then analyzed in NVivo Qualitative Software (Version 10). Detailed process notes, analytic memos, peer debriefing, and the use of visual analytic displays were used to increase the trustworthiness of findings. Results are presented in chapters two, three, and four. Chapter two explores women’s experiences of sexual violence in IPV relationships. Women described how their intimate partners used a combination of sexual abuse, sexual coercion, and sexual assault as a unique weapon of power and control. Chapter three examines women’s sexual risks across the levels of their ecological environment using an intersectional feminist framework. Women’s sexual risks went beyond sexual violence and were influenced by subtle yet pervasive cultural gender norms that reduced their power in relation to their male sexual partners. Chapter four focuses on understanding women’s protective sexual health behaviors in order to inform the development of an intervention that follows women’s natural pathway to care as they heal from victimization to surviving to thriving.