Among married men in Bangladesh, those who reported having abused their wife physically, sexually or both in the previous year were more likely to report having premarital and extramarital sex partners than husbands who reported no such abuse, according to a nationally representative study conducted in 2004.1 Among husbands who reported STI symptoms or diagnose in the year prior to the survey, those who had abused their wife physically were less likely than those who had not to disclose their infection status to their spouse.
Although previous research has shown that women who experience intimate partner violence are at an increased risk for STIs, few studies have examined the relationships between such violence and the sexual risk-taking and sexual health outcomes of abusive husbands or the sexual health risks posed to their wives. Because high levels of intimate partner violence and rapid increases in rates of HIV infection among married women have been documented in South Asia, the researchers sought to examine the associations between men's abuse and their extramarital sexual behavior, STI symptoms and diagnoses, disclosure of infection to spouses and use of condoms while symptomatic.
The data for analysis came from the subsample of 3,096 husbands interviewed in the 2004 MEASURE Bangladesh Demographic and Health Survey; the men provided information on social and demographic characteristics, extramarital sexual relations and intimate partner violence. Chi-square analyses were used to assess the differences in perpetration of intimate partner violence across demographic groups.
The majority of respondents (68%) were between the ages of 26 and 45; 77% reported rural residence. Almost 70% had no more than a primary education. The overwhelming majority (90%) were Muslim; the remainder were Hindu. More than one-third of men reported perpetrating some form of abuse against their wife in the previous year—20% reported physical violence only, 10% sexual violence only and 8% both.
There were significant differences in the perpetration of violence across demographic groups. The proportion of men who had abused their wife in any way in the past year declined with increasing age; this pattern held for each type of violence. In general, men with more education were less likely to abuse their wife. However, men with a secondary education were more likely than those who reported no education to have committed sexual violence only (13% vs. 7%). Higher proportions of poorer men than of wealthier men reported committing any form of violence and perpetrating both physical and sexual violence in the previous year, but this did not hold true for physical violence only or sexual violence only. Muslims were more likely than Hindus to have committed some type of violence against their wife (38% vs. 28%).
Husbands who reported committing physical violence only had greater odds of having engaged in premarital sex (odds ratio, 1.8) and extramarital sex (ever and in the previous year—1.9 and 2.0, respectively); these men also had greater odds of having had STI symptoms or having received an STI diagnosis in the previous year (1.7) and of not disclosing their STI status to their spouse (1.6). Those who reported committing sexual violence only in the previous year were more likely to have had premarital sex (2.3) and to have ever engaged in extramarital sex (2.5). Men who reported both physical and sexual violence in the previous year had greater odds of having had premarital sex (2.8), extramarital sex ever and in the previous year (2.0 and 3.5, respectively) and STI symptoms or an STI diagnosis in the previous year (2.5).
These findings are consistent with those of previous studies conducted in Bangladesh, India and sites in the developed world. The researchers suggest that, given the consistency of their findings with those from other settings, "the implications…may extend beyond the South Asian context and inform a growing global body of evidence linking perpetration of gender-based violence with men's sexual risk behavior. " The authors believe that one of the primary implications is that there is a great need "to both prevent and intervene in men's violence against their wives…not only for preventing the direct and injurious consequences of [intimate partner violence], but also for protecting women from STIs, including HIV. "—L. Melhado "
REFERENCE
1. Silverman JG et al., Violence against women, sexual risk and sexually transmitted infection among Bangladeshi men, Sexually Transmitted Infections, 2007, 83(3):211–215.