Intimate partner violence polyvictimisation and HIV among coupled women in Zambia: Analysis of a population-based survey

Laura K. Beres, Katherine G. Merrill, John McGready, Julie A. Denison, Sheree Schwartz, Izukanji Sikazwe, Michele R. Decker

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalGlobal public health
DOIs
StateAccepted/In press - Jan 1 2019

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Zambia
HIV
Crime Victims
Violence
Population
Demography
Women's Rights
Surveys and Questionnaires
Intimate Partner Violence
Africa South of the Sahara
Sex Offenses
HIV Infections

Keywords

  • HIV
  • IPV
  • polyvictimisation
  • women
  • Zambia

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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title = "Intimate partner violence polyvictimisation and HIV among coupled women in Zambia: Analysis of a population-based survey",
abstract = "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.",
keywords = "HIV, IPV, polyvictimisation, women, Zambia",
author = "Beres, {Laura K.} and Merrill, {Katherine G.} and John McGready and Denison, {Julie A.} and Sheree Schwartz and Izukanji Sikazwe and Decker, {Michele R.}",
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T2 - Analysis of a population-based survey

AU - Beres, Laura K.

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AU - McGready, John

AU - Denison, Julie A.

AU - Schwartz, Sheree

AU - Sikazwe, Izukanji

AU - Decker, Michele R.

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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.

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