PUBLIC HEALTH Violence against wives, sexual risk and sexually transmitted infection among Bangladeshi men

Objective: To assess the relationship between men’s reported violence against wives and their sexual risk behaviours and sexual health. Design, setting and participants: Cross-sectional analyses of a survey of a nationally representative household-based sample of married men in Bangladesh (n = 3096). Main outcome measure(s): Physical and sexual violence against wives during the previous 12 months was assessed and examined for relations to men’s extramarital sexual behaviours and sexually transmitted infection (STI) symptoms or diagnosis during this same period, as well as to men’s disclosure of such infection to wives and condom use while infected. Results: More than 1 in 3 (36.84%) married Bangladeshi men reported physically and/or sexually abusing their wives in the past year. Men perpetrating such violence were more likely to report both premarital and extramarital sex partners (ORadjs 1.80–3.45; 95% CI 1.20 to 8.23); those reporting physical violence were more likely to report STI symptoms or diagnosis in the past year (ORadjs 1.68–2.52; 95% CI 1.24 to 3.73). Men perpetrating physical violence and contracting an STI were somewhat more likely to fail to disclose infection status to wives (ORadj 1.58; 95% CI 0.93 to 2.70) than infected men not reporting such abuse. Conclusions: Violence against wives is common among Bangladeshi men. Men who perpetrate such abuse represent increased risk regarding their wives’ sexual health because they are more likely to both participate in extramarital sexual behaviour and contract an STI compared with non-abusive husbands. Given the growing epidemic of HIV infection among monogamous South Asian women based on intercourse with infected non-monogamous husbands, research and intervention regarding men’s violence in marriage and implications of such behaviour for women’s sexual health should be prioritised.