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Why don’t women insist on condoms? It’s complicated

Updated: June 29, 2012 9:39AM

A woman’s exposure to violence has a negative impact on her sexual behavior.

That’s the conclusion of a recent study from the Miriam Hospital’s Centers for Behavioral and Preventive Medicine.

According to the research findings, women who have witnessed violence (such as neighborhood crimes or domestic violence) or experienced abuse firsthand are more likely to engage in risky sex. They are more likely to have a higher number of sex partners and less likely to use protection and practice other safer sex measures. These women also are more likely to abuse drugs and alcohol.

What accounts for this relationship, and why would witnessing a violent act later cause a woman to put her own body at risk through dangerous sexual activity?

Part of it could be related to psychologist John Money’s theory of love maps. We learn how to love and seek love from watching our parents and the model of their relationship. If their relationship is unhealthy or abusive, it can forever alter the way the children think of love. For example, if a girl grows up in a home where the father is abusive to the mother, she might begin to normalize this type of abuse and to have a hard time differentiating between love and pain.

Many statistics show that women who grow up in abusive homes are more likely to become victimized as adults, and this also could partially explain the results of the Miriam study. Since witnessing violence or experiencing violence causes a woman to be more likely to be physically victimized as an adult, it could be surmised that it also might make her more likely to be sexually victimized as well. She might have a more difficult time negotiating for condom use or saying no to potential partners, and she might feel disengaged or numb to her own body and sexuality. All of this can make promiscuity and unsafe risk more likely, especially if the woman is trapped in a pattern of abusive relationships.

Additionally, growing up in an abusive home can wreak havoc on a child’s self-esteem. Numerous studies have found that children with abusive backgrounds are more likely to grapple with low self-esteem, depression, and anxiety (along with its accompanying self-coping mechanisms such as alcohol/drug abuse, self-harm, promiscuity, etc.). These issues could explain why women who have been exposed to violence are less likely to make efforts to protect themselves and make healthy choices.

However, the study also found that women who simply witnessed violence in their communities also were more likely to engage in risky sex. In other words, they didn’t have to witness abuse in the home or establish a vandalized love map to be at risk for dangerous sexual decisions. This could be because witnessing trauma and violence, can negatively impact a female’s feelings of security and self-worth. She might feel as though she lives in an uncertain world in which condom use and other safer sex practices aren’t important or valuable to her. As her own health and well-being becomes less important, so do her sexual decisions and safer sex measures.

Furthermore, statistics have found that women with lower-income backgrounds are those who are most likely to experience abusive relationships (and these women are also more likely to live in high-crime neighborhoods where violence is common). Not only are they at more risk, but they also are less likely to have resources and education that can help them break this cycle. They probably will be less likely to have access to adequate healthcare and they might not have the necessary tools and information that they need to practice safer sex. All of this creates a perfect storm that can drain a woman’s self-worth and lead to risky sex and dangerous sexual decisions.

The good news is that studies such as this highlight the myriad emotions and issues that lay behind condom use. As this study shows, sexual decisions tend to be related to a woman’s inner emotions and feelings of security, so it is simply isn’t enough to encourage women to ask for condom use or to protect themselves. We have to empower them to want to protect themselves and to help them realize that their bodies are something of worth and value, and something that they have the right (and the responsibility) to protect.

Dr. Berman is the star of “In The Bedroom with Dr. Laura Berman” on OWN and director of

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