Violence against wives and associations with inconsistent condom use among clients of female sex workers in Haiti

Objective: estimate the lifetime prevalence of emotional, physical and sexual violence towards intimate partners among clients of FSWs in Haiti and examine the associations between intimate partner violence (IPV) and current condom use.
Methods: Cross-sectional survey conducted among 333 clients in commercial sex sites of St-Marc and Gonaives, Haiti. A structured questionnaire, translated in Creole, was used to collect data on socio-demographic characteristics, behaviours, and violence against sexual partners.
Results: Twenty-one percent of clients reported lifetime emotional IPV, 16.5% physical violence and over one-quarter (28.8%) ever forced them to have a sexual intercourse. Violence against the different type of sexual partners were highly correlated. In logistic regression models, history of emotional or physical IPV were both predictors of inconsistent condom use with intimate and occasional partners (OR 2.63; 95% CI 1.33-5.19 and OR 2.40; 95% CI 1.15-5.04, respectively).  History of physical, but not emotional, IPV was also a predictor of inconsistency of condom use with FSWs (OR 1.92; 95% CI 111.05-3.52).  However, no significant associations were observed between lifetime sexual IPV and condom use with all partners.
Conclusions: The prevalence of lifetime IPV is high among clients of FSW in Haiti. Violence is perpetrated not only against their intimate partners, but also against their casual partners and FSW. Moreover, history of emotional and physical IPV were strong predictors of inconsistent condom use. The fact that these abusive men are more likely to be infected with a STI and inconsistent condom users put their sexual partners at high risk of infection.