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Wednesday, January 8
Wed, Jan 8, 10:30 AM - 12:15 PM
Measuring Health Inequities to Inform Policy

Reproductive coercion sometimes works: Evaluating whether young Black women reporting reproductive coercion are more likely to become pregnant (307802)


Ralph J DiClemente, New York University College of Public Health 
*Janet E Rosenbaum, SUNY Downstate SPH 

Keywords: matching, sensitivity analysis, tetrachoric correlation, condoms, young adults, HIV prevention, unplanned pregnancy prevention, reproductive coercion,

Men engaging in reproductive coercion may coerce, force, or deceive female partners into pregnancy. This study evaluates whether women reporting reproductive coercion in the past 3 months are more likely to be pregnant 3 months later in a sample of African-American women ages 18-25 in Atlanta, Georgia in 2012-14 (n=560) surveyed at baseline, 3, 6, 9, and 12 months. We used logistic regression controlling for baseline fertility intentions after full matching on 22 baseline measures of demographics, power inequality, and risk behavior. At 3 months, 15% of women reported coercion, which was associated with greater odds of pregnancy at 6 months: 11.3% were pregnant vs. 4.6% among matched women reporting no coercion (p=0.06) (AOR 2.95, 95% CI (1.16, 6.98), p=0.02). Among women pregnant after coercion, only 15% wanted to be pregnant then or sooner. Women reporting reproductive coercion are at greater risk of unwanted or mistimed pregnancies, as well as greater HIV risk. Clinicians should screen patients for reproductive coercion, use semen exposure biomarkers such as PSA or Yc-PCR to identify condom sabotage/stealthing, and refer women experiencing coercion to supportive services.