Violence against HIV-Positive urban poor women is most commonly perpetrated by persons who are not primary partners

OBJECTIVE: To determine the prevalence and correlates of violence against HIV+ urban poor women perpetrated by primary-partners (PPs) and persons who are not primary-partners (non-PPs). METHODS: Between June 2008 and December 2009, HIV-positive women were recruited from community-based San Francisco venues, including free meal programs and homeless shelters. Interview data were analyzed using multivariable logistic regression to establish independent correlates of violence in the past 6-months. RESULTS: Among 125 women, the median age was 48, 74% were of non-white race/ethnicity and 54% completed high school. Violence experienced included emotional violence by PPs and non-PPs (25% PP vs. 46% non-PP, p<0.01), physical violence (9% PP vs. 14% non-PP, p=0.17) and sexual violence (6% PP vs. 18% non-PP, p=0.02). Unmet subsistence needs was the strongest correlate of violence by a non-PP (Adjusted OR [AOR] =5.79). Heavy alcohol use was the strongest correlate of violence by a PP (AOR=3.07), while non-white race/ethnicity was protective in this population (AOR=0.28). CONCLUSION: All types of violence were more commonly perpetrated by persons who were not primary partners, suggesting that most of the violence against urban poor HIV+ women is not domestic violence. While heavy alcohol use is a behavior that can be changed, unmet subsistence needs and race are not immediately modifiable and put women at higher risk for violence. Addressing basic subsistence needs could serve to reduce violence against HIV+ urban poor women. Further, the data suggest that focusing on domestic abuse may miss most of the violence taking place in this population.