Archives of Sexual Behavior, Vol. 32, No. 6, December 2003, pp. 499–511 ( C  2003) Intimate Partner Violence and Safer Sex Negotiation: Effects of a Gender-Specific Intervention Rita M. Melendez, Ph.D., 1,3,4 Susie Hoffman, Dr.P.H., 1,2,3 Theresa Exner, Ph.D., 1,3 Cheng-Shiun Leu, Ph.D., 1,3 and Anke A. Ehrhardt, Ph.D. 1,3 Received October 17, 2002; revision received February 19, 2003; accepted February 19, 2003 This study examined the effects of a gender-specific HIV/STD prevention intervention with two dosage levels (four-session, eight-session) among women reporting physical abuse by a current or recent (past year) intimate partner. From 360 women included in the full randomized trial, we conducted subgroup analyses among 152 women who experienced partner physical abuse within the past year. Unprotected vaginal and anal sex occasions and negotiation skills were examined as outcomes. We also assessed whether the intervention increased previously abused women’s subsequent risk of physical abuse. Among abused women, those in the eight-session, but not the four-session, intervention decreased their unprotected sex occasions or maintained consistent safer sex at both 1-month (OR = 3.63, 95% CI = 1.50–8.80) and 1-year (OR = 2.88, 95% CI = 1.17–7.10) postintervention. In the short-term, abused women in both the four- and eight-session groups had a greater odds of using an alternative strategy (e.g., refusal, “outercourse,” or mutual testing) and of having a safer sex discussion with their partners relative to their controls, and they scored higher on intention to negotiate safer sex. The intervention did not increase or decrease the incidence of subsequent abuse during the 1-year follow-up period. A gender-specific intervention that focuses on negotiation skills in the context of potentially abusive partners benefits, and does not appear to harm, recently abused women. KEY WORDS: abuse; sexual negotiation; intervention; prevention; HIV/AIDS. Violence against women is widespread in the U.S. population. A national probability survey conducted in 1998 found that one out of every four U.S. women has been physically assaulted and/or raped by an intimate partner (Tjaden & Thoennes, 2000). Intimate partner violence in- cludes physical or sexual assault by a person with whom the victim has had an intimate relationship (Council on Ethical and Judicial Affairs, 1992). The prevalence of in- timate partner violence among women with HIV or at risk 1 HIV Center for Clinical and Behavioral Studies, New York State Psy- chiatric Institute, New York and Columbia University, New York, New York. 2 Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, New York. 3 Department of Psychiatry, Columbia University, New York, New York. 4 To whom correspondence should be addressed at the HIV Center for Clinical and Behavioral Studies, 1051 Riverside Drive, Unit 15, New York State Psychiatric Institute, New York, New York 10032-2695; e-mail: rm960@columbia.edu. for HIV may be as high as 67% (Cohen et al., 2000). The association between a history of abuse and HIV in- fection may be explained in part by the fact that abused women face difficulty in effectively negotiating sexual matters with their partners, thus increasing their risk sig- nificantly (Amaro, 1995; Maman, Campbell, Sweat, & Gielen, 2000). A breadth of skills is involved in negotiating safer sex, including the ability to comfortably discuss sexual mat- ters, clearly assert one’s sexual needs and desires, avoid or refuse to engage in intercourse when a partner will not use condoms or engage in “outercourse” (sexual con- tact without vaginal, anal, or oral intercourse). Safer sex negotiation poses challenges for all women. Constrained by traditional gender roles, women may find it difficult to talk about sex and assert their needs (Amaro, 1995; Gomez & Marin, 1996; McCormick, 1994; Perper & Weis, 1987; Williams, Gardos, Ortiz-Torres, Tross, & Ehrhardt, 2001). 499 0004-0002/03/1200-0499/0 C  2003 Plenum Publishing Corporation