Role of Physical and Sexual Abuse in Initiation and Condom Use among Rural and Urban Women in Tanzania

Background: This study examined how traditional gender roles moderated the relationship between sexual and physical violence and HIV protective behaviors in urban and rural areas of Tanzania. Previous research has shown that traditional gender roles along with other factors contribute to contexts in which women have a limited ability to influence their partner's decisions; often leaving them susceptible to STIs. It was hypothesized that 1) individuals with traditional views would be less likely to use or initiate condom use and 2) HIV protective behaviors would be exhibited differently based on region and abuse history.

Methods: Secondary data analysis was conducted using data collected from a cross-sectional WHO household survey administered to 3,632 women. Descriptive and multivariate analyses were conducted to examine the relationship between abuse and HIV protective behaviors.

Results: The results demonstrated that traditional gender roles and occurrences of physical and sexual violence were more prevalent in rural areas of Tanzania; while modern views were found in urban areas. Significant differences in risky behaviors were also found based on location, χ2 (1, n=2880) 47.93, p<.001, phi=-.13, and abuse status, χ2 (1, n= 2704) = 54.33, p< .001, phi=.14.

Conclusion: The findings demonstrated that there were higher occurrences of abuse and traditional views of gender roles in rural areas of Tanzania and those factors put women at higher risk for contracting HIV. Future efforts to decrease violence against women and HIV prevalence within sub-Saharan Africa should work to increase knowledge of HIV and alter the beliefs that decrease protective behaviors.