Perceived HIV Risk and Coercive Sex: Evidence from Rakai, Uganda

Michael Koenig, Johns Hopkins University
Tom Lutalo, Rakai Project
Feng Zhao, Johns Hopkins University
Noah Kiwanuka, Rakai Project
Fred Wabwire-Mangen, Makerere University

This study presents findings from a community-based survey of 4279 reproductive-aged women in the Rakai District of Uganda on the issue of coercive sexual relations. One in four women reported having ever experienced coercive sex with their current partner. Younger age at first intercourse, alcohol consumption, and perceptions of the male partner's HIV risk emerged as strongly and positively related to the risk of coercive sex. Women who perceived their partner to be at highest risk of HIV experienced risks of coercive sex almost three times higher than women in lower risk partnerships, with supplemental analysis of longitudinal data providing evidence that coercive sex appears to be a direct consequence of shifts in women's perceptions of their male partners' HIV risk. Our findings highlight the possible importance of coercive sex in fueling the continuing HIV epidemic in Uganda, and the need to address this issue within current HIV prevention programs.