Exploring the association between HIV and violence: young people's experiences with infidelity, violence and forced sex in Dar es Salaam, Tanzania.

CONTEXT Prior research has shown a strong correlation between HIV infection and a history of intimate partner violence, particularly among young women. However, the role violence plays in the sexual relationships of young people in Sub-Saharan Africa is not well understood. METHODS Locally trained interviewers conducted semi-structured interviews with 40 young men and 20 young women aged 16-24 who were recruited from public venues in Dar es Salaam, Tanzania. RESULTS The participants described complex interactions among violence, forced sex and infidelity in their sexual relationships. Men who were violent toward female partners also frequently described forced sex and sexual infidelity in these partnerships. Men with multiple concurrent sexual partners reported becoming violent when their female partners questioned their fidelity, and reported forcing regular partners to have sex when these partners resisted their sexual advances. Youth who felt that violence and forced sex could not be justified under any circumstances were often those who had not yet initiated sexual relationships or who were in monogamous partnerships. CONCLUSIONS The association between HIV and violence identified among young people in prior research may be partially explained by their experiences with infidelity and forced sex in their intimate partnerships. HIV prevention interventions that fail to take into account the infidelity, violence and forced sex frequently involved in youth's sexual relationships will have a limited impact.