142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Intimate Partner Violence and HIV risk: The role of cover-up, shame and fear

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 5:30 PM - 5:45 PM

Alejandra Mijares, MPH , U.S. Health Division, Public Health and Epidemiology, Abt Associates, Atlanta, GA
Laura Salazar, PhD , School of Public Health, Georgia State University, Atlanta, GA
Nicole Pitts, B.S. , Dynamics Research Corporation, Andover, MA
Rachael Wendlandt, B.A. , US Health, Abt Associates, Atlanta, GA

Women who experience intimate partner violence (IPV) are vulnerable to HIV infection. Forty-four percent of African American women experience IPV, and comprise 64% of new HIV infections among women. Few CDC best-evidenced HIV interventions address IPV.  This study triangulated qualitative and quantitative data to identify individual and relational factors that may increase risk for HIV in women who experience IPV.


We recruited African American women (n=48) who reported experiencing IPV. We conducted qualitative interviews, and administered a survey measuring psychological and relational factors, and risk behaviors.  Participants were tested for three non-viral STIs. We performed descriptive statistical analysis, and coded qualitative data.


Analyses suggest that participants’ cover-up of IPV is an important factor in the relationship between IPV and HIV risk: 62.5 % reported covering-up the abuse. Of those, 30% feared condom negotiation and 79.2% perceived low relationship power. Additionally, 31% of the total sample tested positive for an STI, 73% of whom covered-up the abuse. Triangulation with qualitative data, indicated that individual feelings of shame (e.g. shame of IPV), and fear (e.g. fear of partner) play a significant role in their cover-up of the IPV they experienced.


Shame and fear are associated with experiencing IPV and may lead to cover-up of IPV and place women at an increased risk for HIV. Cover-up may increase isolation and affect help-seeking behaviors making intervention efforts less likely. Interventions aimed at reducing HIV infection among women should address IPV as well as its psychological and behavioral consequences.

Learning Areas:

Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe the association between intimate-partner violence and risk for HIV. Explain how interventions aimed at reducing risk for HIV should address intimate partner violence. Articulate how interventions for women in violent relationships need to address the role of cover-up, shame and fear.

Keyword(s): Women and HIV/AIDS, Violence & Injury Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 8 years of experience working in HIV prevention and research. My work has focused on vulnerable populations at risk for HIV.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.