Violence Against Intimate Partners and Associations with Inconsistent Condom Use Among Clients of Female Sex Workers in Haiti

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Abstract: As pointed out by Couture et al., patrons of sex workers are at high risk for contracting human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) and contribute to the spread of infection in the general population through unprotected sex. In fact, clients are considered a bridge population, potentially transmitting infection between the sex workers and women from the general population. This transmission makes the wives, girlfriends, and casual sex partners of sex worker patrons especially vulnerable to HIV infection. What is particularly interesting in this article is the examination of the relationship between HIV risk behaviors and intimate partner violence (IPV) among men in Haiti. The results of this study support previous findings suggesting that men perpetrating IPV engage in sexual behaviors that increase the risk of STI and HIV for intimate partners, in particular, non-condom use. As a result, abusive men may put their intimate partners at higher risk of contracting HIV/STIs. This finding is a cause for concern among clients of sex workers who are at higher risk of HIV and spreading the disease in the general population. The findings by Couture et al. highlight the importance of culturally adapted interventions addressing both violence and HIV risk behaviors. Other studies have also demonstrated that HIV prevention programs integrating IPV can reduce negative attitudes and violence. Intervention programs in Haiti should take into consideration societal norms concerning violence against women, considering the high occurrence of violence in this culture. Community-wide prevention programs are key to dealing with this major public health challenge, which has only been exacerbated by the other extraordinary stressors on the people of Haiti.