Full bibliography

Introduction: Intimate partner violence (IPV) is an important determinant of poor sexual and reproductive health. One’s sense of sexual autonomy may be an important concept in the context of IPV and sexual and reproductive health outcomes. Compromised sexual autonomy may explain the risk of poor sexual and reproductive health among individuals who experienced IPV; yet few studies have examined the role of sexual autonomy. The current study examined the mediating effects of sexual autonomy on the association between recent IPV, sexual risk and HIV-related worry. Methods: One hundred ninety-eight sexually active women and men involved in past-year romantic partnerships completed an online survey in 2016. Path analysis was used to test the direct and indirect effects of sexual autonomy. Results: Recent IPV predicted lower sexual autonomy (B = −.29, SE =.15, p <.05), unwanted condomless sex (aOR = 3.38, 95% CI 1.63–7.02), coercive sexual risk (aOR = 25.91, 95% CI 5.02–133.75), and HIV-related worry (aOR = 5.44, 95% CI 1.44–20.57). Lower sexual autonomy predicted unwanted condomless sex (aOR =.98, 95% CI.96–.99), coercive sexual risk (aOR =.95, 95% CI.90–.99), and HIV-related worry (aOR =.92, 95% CI.90–.97). Sexual autonomy mediated the association between IPV and HIV-related worry (indirect effect OR = 1.39, 95% CI 1.01–3.63). Conclusions: Recent IPV experiences can weaken one’s sexual autonomy, which in turn creates concerns about acquiring HIV. HIV prevention programming should address the implications of IPV, promote sexual safety strategies, and develop tailored support to increase sexual autonomy among individuals navigating violence. Policy Implications: Findings can inform the integration of trauma-informed policies and IPV screening practices in comprehensive sexual health programmatic initiatives. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.