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Ns vary slightly from Table 1 due to missing data on control variables. Discussion Sexual violence is significantly associated with condom use, pregnancy experience, and recent STI symptoms among youth socializing at venues where young people meet sexual partners in Port-au-Prince. While not population-based, PLACE data may be more useful to program planners given that the method identifies locations where sexually-active youth congregate [ 8 ].
Limitations exist with the present analysis. First, these findings represent only associations, not causal pathways. While the STI symptom measure represents the previous four weeks, pregnancy is a lifetime measure. Thus, the temporality of sexual violence and reproductive health outcomes is unclear. Additionally, we do not find a significant association between sexual violence and transactional sex in all models, and condom use was not significant in gender-stratified models.
While sexual violence may not be related to these behaviors, it is also possible that our small sample size lacks power to detect significant differences in these measures. Finally, sexual violence is challenging to measure and often under-reported [ 9 ]. More details about the circumstances, perpetrators, frequency and intensity of sexual violence experiences are needed to inform the development of violence and HIV prevention programs. This and other studies [ 1 - 3 ] indicate a need for programs for both young men and women to prevent sexual violence and promote protective behaviors among youth who have previously experienced sexual violence.
While pregnancy and STI symptoms may be directly associated with sexual violence, victims of sexual violence may also have limited power in negotiating for condom and contraceptive use in future sexual encounters. Sexual violence may also establish an unhealthy pattern of sexual risk-taking throughout life [ 10 ]. Screening programs in schools could help to identify victims of sexual violence; these youth could be offered counseling, referrals, and training on sexual negotiation and refusal skills.
In addition, interventions could take place in these high-risk venues to reach out-of-school youth, offering condoms to all youth and counseling and referrals for victims of sexual violence. Venue-based interventions have the potential to target high-risk youth and to reduce sexual violence and its deleterious effects among youth in Haiti.