TY - JOUR
T1 - Intimate partner violence, HIV and sexually transmitted infections in fishing, trading and agrarian communities in Rakai, Uganda
AU - Sabri, Bushra
AU - Wirtz, Andrea L.
AU - Ssekasanvu, Joseph
AU - Nonyane, Bareng A.S.
AU - Nalugoda, Fred
AU - Kagaayi, Joseph
AU - Ssekubugu, Robert
AU - Wagman, Jennifer A.
N1 - Funding Information:
Dr. Sabri’s work on the design of the analysis plan, analysis and interpretation of data and writing the manuscript was supported by Eunice Kennedy Shriver National Institute for Child Health & Human Development (K99HD082350 and R00HD082350) and by the Johns Hopkins University Center for AIDS Research (P30 AI094189). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Rakai Community Cohort Study (RCCS) was funded by the Bill & Melinda Gates Foundation (22006.02) and the US National Institutes of Health (U1AI51171). The Bill and Melinda Gates Foundation and US National Institutes of Health contributed to the support of other co-authors in the design of the parent study, data collection, interpretation and writing of the manuscript. The Fogarty International Center (5D43TW001508 and 2D43TW000010–19-AITRP) contributed to training of the RHSP’s junior investigators.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/5/17
Y1 - 2019/5/17
N2 - Background: Intimate partner violence (IPV), HIV and sexually transmitted infections (STI) can contribute to disparities in population health, depending on the individual, social and environmental factors characterizing a setting. To better understand the place-based determinants and patterns of these key interrelated public health problems in Uganda, we compared risk factors for IPV, HIV and STI in fishing, trading and agrarian communities in Rakai, Uganda by gender. Method: This study used cross-sectional data collected from 14,464 sexually active men (n = 6531) and women (n = 7933) as part of the Rakai Community Cohort Study, a population-based open cohort study of men and women aged 15-49 years. We used multilevel modified poisson regression models, which incorporated random intercepts for community and households. Factors associated with IPV, HIV and STI were assessed separately for men and women in fishing, trading and agrarian communities. Results: A larger proportion of participants in the fishing communities than those in trading and agrarian communities were HIV positive, engaged in HIV risk behaviors, had STI symptoms and reported perpetration of or victimization by IPV. Female gender was a shared correlate of IPV, HIV and STI in the fishing communities. Engagement in multiple sexual relationships or partner's engagement in multiple relationships were shared correlates of IPV, and HIV in agrarian communities and IPV and STI in trading communities. Conclusion: Programs should target factors at multiple levels to reduce risk for syndemic conditions of HIV, STI and IPV in Rakai, Uganda particularly among men and women in fishing communities.
AB - Background: Intimate partner violence (IPV), HIV and sexually transmitted infections (STI) can contribute to disparities in population health, depending on the individual, social and environmental factors characterizing a setting. To better understand the place-based determinants and patterns of these key interrelated public health problems in Uganda, we compared risk factors for IPV, HIV and STI in fishing, trading and agrarian communities in Rakai, Uganda by gender. Method: This study used cross-sectional data collected from 14,464 sexually active men (n = 6531) and women (n = 7933) as part of the Rakai Community Cohort Study, a population-based open cohort study of men and women aged 15-49 years. We used multilevel modified poisson regression models, which incorporated random intercepts for community and households. Factors associated with IPV, HIV and STI were assessed separately for men and women in fishing, trading and agrarian communities. Results: A larger proportion of participants in the fishing communities than those in trading and agrarian communities were HIV positive, engaged in HIV risk behaviors, had STI symptoms and reported perpetration of or victimization by IPV. Female gender was a shared correlate of IPV, HIV and STI in the fishing communities. Engagement in multiple sexual relationships or partner's engagement in multiple relationships were shared correlates of IPV, and HIV in agrarian communities and IPV and STI in trading communities. Conclusion: Programs should target factors at multiple levels to reduce risk for syndemic conditions of HIV, STI and IPV in Rakai, Uganda particularly among men and women in fishing communities.
KW - HIV
KW - Intimate partner violence
KW - Sexually transmitted infections
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U2 - 10.1186/s12889-019-6909-8
DO - 10.1186/s12889-019-6909-8
M3 - Article
C2 - 31101045
AN - SCOPUS:85065909479
SN - 1471-2458
VL - 19
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 594
ER -