When It's a Belly, Not a Bruise

Last week, Alternet published a great article examining the sexual and reproductive violence that takes place in many abusive teen relationships.

But even as a growing body of research underscores the role male partners play in condom use and negotiation, no suggestion was made that those stats might include some girls who are forgoing condoms against their will, even those bolstered by condom-friendlier sex ed.

"The person you're 'negotiating' condom use with may not be interested in negotiation," says Miller.

"The picture out there is 'just get women birth control,' " adds Esta Soler, president of the Family Violence Prevention Fund, which has launched a public awareness campaign about reproductive abuse in relationships. "But, because of coercion or sabotage, they may not have control over whether they use it."

And it's not just about pregnancy. Dr. Anne Teitelman, Assistant Professor in the School of Nursing at the University of Pennsylvania, is an expert on partner abuse and HIV risk. In her published review on this link among adolescent girls, she found six studies identified an association between intimate partner violence and increased risk for HIV (as in condom non-use). Among adolescent girls, survivors of partner abuse are significantly more likely than others to be diagnosed with an STD.

Dr. Teitelman's research findings also indicate that verbal abuse, as well as physical abuse, is linked with increased HIV risk among adolescent girls.

Teitelman, who is also a Family Nurse Practitioner, observed this association firsthand, before studies began to confirm the link.

"We're giving teens all this information about prevention in the clinic, and yet I see them back all the time for STI testing," she says. So, she began to ask, " 'What's not working on our end? What are the obstacles in their lives that are making this difficult for them?' I was not a partner-abuse researcher before, but I became one because that was one of the major answers."

What drives young men to abuse in this way?

"It's clearly out-and-out control of a woman's body. Control for control's sake," says Miller. It's an urge that stems, experts say, from an inability to manage their own fears and insecurities.

In one 2007 study, some boys acknowledged outright that they insisted on condomless sex as a way to establish power over female partners. (There is evidence of analogous male-on-male sexual violence, but it hasn't been studied in depth.)

Other research found that some men took a woman's request for a condom as an accusation of cheating, or an admission that she had slept around or strayed. And for some, yes, the goal is fatherhood -- but not so much of the "involved" variety; rather, it's a desire to mark one woman as "mine" forever. Or, according to Patti Giggans, young men in gangs say, "I'm not gonna be around forever. I've gotta leave my legacy."

This issue has been discussed here before (18% of Young US Women Have Been Raped, Forced Pregnancy as Abuse ), and is one that we hear about regularly from women using our programs. It isn't just teens, but sexual and reproductive violence often starts in the teenage years and continues as the relationship continues. Some women are victimized in this way by multiple men over time. It is just one of many ways abusers try to assert power and control over their partners, but it is one of the most impacting. Bruises heal, but a child is always there, and the more children you have, the harder it is to get free.