Interpersonal violence, substance use, and HIV-related behavior and cognitions: a prospective study of impoverished women in Los Angeles County.

In a sample of 810 women residing in shelters and low-income housing, this 6-month prospective study investigated associations of recent violence and substance use with HIV-related sexual behaviors and cognitions. Controlling for baseline sexual behavior, partner violence at baseline was associated with less sexual activity and unprotected sex at follow-up. Non-partner violence at baseline was associated with a higher likelihood of being sexually active at follow-up (housed women), but less frequent sexual activity. Drinking to intoxication at baseline was associated with less ability to refuse unwanted sex (sheltered women) and higher perceived susceptibility to HIV at follow-up, whereas baseline drug use was associated with greater perceived ability to refuse unwanted sex and condom use self-efficacy. These findings differed in important ways from cross-sectional associations, emphasizing the need for additional prospective research to fully understand the impact of violence and substance use on women's HIV-related behaviors and cognitions.