TY - JOUR
T1 - Intimate partner violence polyvictimisation and HIV among coupled women in Zambia
T2 - Analysis of a population-based survey
AU - Beres, Laura K.
AU - Merrill, Katherine G.
AU - McGready, John
AU - Denison, Julie A.
AU - Schwartz, Sheree
AU - Sikazwe, Izukanji
AU - Decker, Michele R.
N1 - Funding Information:
This work was supported by National Institute of Mental Health of the National Institutes of Health: [grant numbers F31MH109378, F31MH11682101]; Johns Hopkins University Center for AIDS Research: [grant number 1P30AI094189]. We thank Dr. Keri Althoff for her input on the analysis plan.
Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/4/2
Y1 - 2020/4/2
N2 - Women in sub-Saharan Africa are disproportionately at risk for the dual epidemics of intimate partner violence (IPV) and HIV. Little is known about how specific violence profiles affect women’s HIV risk, limiting effective intervention. We analysed couples’ data from the Zambia Demographic and Health Survey 2013–2014 to evaluate relationships among IPV, male partner HIV status and women’s HIV status. We considered the individual and combined effects of physical, sexual, emotional, and high controlling behaviour violence and accumulated violence exposure, respectively. Among partnered women, 48.9% (n = 2,812) experienced IPV victimisation, of whom 52.1% (n = 1,465) reported polyvictimisation (experiencing two or more violence types). Female HIV prevalence was 13.2%. Adjusted for demographics, HIV was significantly higher for women who experienced three (17.3%, aPR 1.33, 95%CI: 1.04–1.69, p = 0.02) or four (22.1%, aPR 1.66, 95%CI: 1.23–2.26, p ≤ 0.01) types versus no IPV. Violence including emotional and/or high controlling victimisation was associated with female HIV infection (aPR: 1.31, 95%CI: 1.09–1.57, p = 0.01). Physical and/or sexual violence victimisation in the absence of other victimisation was not associated with HIV (aPR: 0.92, 95%CI:0.73–1.15, p = 0.46). IPV and HIV interventions are incomplete without addressing emotional and controlling IPV and the role of coercive relationship dynamics in transmission risk.
AB - Women in sub-Saharan Africa are disproportionately at risk for the dual epidemics of intimate partner violence (IPV) and HIV. Little is known about how specific violence profiles affect women’s HIV risk, limiting effective intervention. We analysed couples’ data from the Zambia Demographic and Health Survey 2013–2014 to evaluate relationships among IPV, male partner HIV status and women’s HIV status. We considered the individual and combined effects of physical, sexual, emotional, and high controlling behaviour violence and accumulated violence exposure, respectively. Among partnered women, 48.9% (n = 2,812) experienced IPV victimisation, of whom 52.1% (n = 1,465) reported polyvictimisation (experiencing two or more violence types). Female HIV prevalence was 13.2%. Adjusted for demographics, HIV was significantly higher for women who experienced three (17.3%, aPR 1.33, 95%CI: 1.04–1.69, p = 0.02) or four (22.1%, aPR 1.66, 95%CI: 1.23–2.26, p ≤ 0.01) types versus no IPV. Violence including emotional and/or high controlling victimisation was associated with female HIV infection (aPR: 1.31, 95%CI: 1.09–1.57, p = 0.01). Physical and/or sexual violence victimisation in the absence of other victimisation was not associated with HIV (aPR: 0.92, 95%CI:0.73–1.15, p = 0.46). IPV and HIV interventions are incomplete without addressing emotional and controlling IPV and the role of coercive relationship dynamics in transmission risk.
KW - HIV
KW - IPV
KW - Zambia
KW - polyvictimisation
KW - women
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U2 - 10.1080/17441692.2019.1686532
DO - 10.1080/17441692.2019.1686532
M3 - Article
C2 - 31710273
AN - SCOPUS:85074976814
SN - 1744-1692
VL - 15
SP - 558
EP - 570
JO - Global public health
JF - Global public health
IS - 4
ER -