142nd APHA Annual Meeting and Exposition

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Intimate partner violence and HIV-infection among women in Zimbabwe: A complex interplay

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 9:30 AM - 9:50 AM

Clea Sarnquist, DrPH, MPH , Department of Pediatrics, Stanford University, Menlo Park, CA
Jennifer Kang, MPH
Precious Moyo, MS
Lynda Stranix-Chibanda, MD , University of Zimbabwe, Harare
Valerie Tagwira, MD
Diana Chang , Division of Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, CA
Yvonne Maldonado, MD , School of Medicine, Stanford University, Stanford, CA

Background: HIV-infected women may be at high risk of intimate partner violence (IPV), and IPV, especially sexual violence, puts women at risk for HIV acquisition.

Objectives: (1) describe the prevalence of IPV among HIV-infected women in Zimbabwe, and (2) assess associations between IPV and HIV disclosure.  

Methods: Survey data from 98 HIV-infected women (pregnant at baseline) were collected in 2011-12 at baseline and three months post-partum.

Results: Over 75% of participants experienced at least one of the following from a partner: controlling behavior (73%), or physical (34%), sexual (15%), or emotional abuse (43%). Furthermore, 36/98 (36.7%) women reported sexual violence or moderate/severe physical violence and 14/36 (38.9%) sustained an injury as a result. Women experiencing any one kind of violence were significantly more likely to experience a second and/or third type of violence (p<0.02). Women experiencing controlling behavior (p=0.02) or emotional abuse (p=0.058) reported that their partners were less likely to disclose their HIV status. There were no significant associations between IPV and women disclosing their own HIV status.

Conclusions: IPV is a significant problem in this HIV-infected population, suggesting a need for  evidence-based interventions and policy changes to reduce IPV. Certain types of IPV were associated with decreased HIV disclosure. Sexual violence clearly puts women at risk of HIV; our findings suggest that emotional abuse and controlling behavior may also increase HIV risk by decreasing the likelihood of HIV disclosure before sex. These findings support the need for violence prevention in high HIV-prevalence communities.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe levels and types of IPV faced by HIV-infected women in Zimbabwe. Assess the effect of IPV on HIV disclosure. Discuss the associations between HIV and IPV. Identify policy change and intervention options to reduce IPV.

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

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been evaluating and managing public health interventions and research programs for over 15 years. My major area of expertise is the implementation and evaluation of interventions to improve child and maternal health both globally and within the U.S. I am particularly focused on multidisciplinary work that brings together expertise from varying fields and organizations. I have extensive experience implementing and evaluating HIV and reproductive health interventions both globally and in the U.S.
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.