Strength in the Midst of Pain: Abuse as a Predictor of Sexual Relationship Power

  • Social Exchange Theory suggests that heterosexual power inequities influence sexual negotiation.

  • The Theory of Gender and Power adds that a history of abuse may increase the power differential and disempower women from advocating for their own best interests.

  • The aim of this research was to explore the association of abuse experiences (child sexual abuse and adult physical/sexual violence) to sexual relationship power among Black substance-abusing women, in an attempt to discover whether disparities in the power to negotiate sexual decision-making may partly explain the higher rates of new HIV infection among heterosexual Black women, relative to White and other racial/ethnic heterosexual women.

    The study was a secondary analysis of baseline data collection from 124 Black women in 12 drug treatment programs across the United States who initially participated in an HIV risk reduction trial conducted within the NIDA CTN (CTN-0019: Reducing HIV/STD Risk Behaviors: A Research Study for Women in Drug Abuse Treatment).
    The findings revealed that adult sexual abuse, but not childhood sexual or adult physical abuse, was associated with lower relationship control and decision-making dominance as measured by the Sexual Relationship Power Scale.

    Conclusions: These findings suggest that a history of adult sexual abuse may disempower Black substance-abusing women from negotiating for safer sex. That argues for addressing a history of adult sexual abuse as a strategy for empowering women to advocate for their sexual health. Designing and implementing sexual risk reduction interventions that address adult sexual violence may enhance the relationship power of Black substance-abusing women and in turn may promote safer sex practices.


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    Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.

    Articles were written based on the following published research:

    Ahuama-Jonas C, et al. Strength in the Midst of Pain: Abuse as a Predictor of Sexual Relationship Power among Substance-abusing Black Women. Journal of Ethnicity and Substance Abuse 2017 (in press).