Violence Prevention in Low- and Middle-Income Countries Finding a Place on the Global Agenda: Workshop Summary (2008) / Chapter Skim
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The Intersection of Violence Against Women and HIV/AIDS--Jacquelyn C. Campbell, Marguerite L. Baty, Reem Ghandour, Jamila Stockman, Leilani Francisco, Jennifer Wagman
The Intersection of Violence Against Women and HIV/AIDS--Jacquelyn C. Campbell, Marguerite L. Baty, Reem Ghandour, Jamila Stockman, Leilani Francisco, Jennifer Wagman
Pages 149-166
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. While VAW can take on many forms including sexual violence that occurs during times of conflict, the scope of this paper primarily is a focus on intimate partner violence and the associated research regarding the overlap with HIV risk.
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As background for this most recent effort, this paper will provide a review of the existent literature, both in the United States and internationally; highlight the areas of new research; and propose directions for initiatives by which the complex interface of HIV and IPV can be addressed. Review Process Search Strategy Pubmed, PsychINFO, and Scopus databases were searched using the following key words: domestic violence, intimate partner violence, relationship abuse, physical abuse, sexual abuse, HIV/AIDS, condom use, sexual negotiation, sexual risk reduction, intervention, and prevention.
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In the United States, approximately 1.3 million women are physically assaulted by an intimate partner compared to 835,000 men (CDC 2006)
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. Lifetime prevalence estimates of forced sex by an intimate partner varied from 4 percent in Serbia and Montenegro to 46 percent in Bangladesh and Ethiopia provinces (Garcia-Moreno et al.
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(2000) found a similar, statistically significant difference between HIV-positive and HIV-negative women experiencing physical or sexual intimate partner violence in the past year (21 vs.
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Other studies have studied prevalence of other STIs or STIs in general among abused versus nonabused women. Wingood and colleagues found that women who had experienced both physical and sexual violence, compared to women who reported sexual abuse alone, were more likely to have had a recent STI and to have been threatened when negotiating condom use (Wingood et al.
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The review highlights the need for additional research to better understand the direction of causality and the context of both abuse among teen partners and HIV risk behavior. IPV and HIV: Mutual Risk Factors Prevalence studies have called attention to the overlap in HIV and IPV in women's lives and have demonstrated that women in abusive relationships are at a compounded risk for HIV infection.
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. Lichtenstein and others found that abusive partners used deliberate HIV infection, lack of disclosure about known serostatus, and forced injection drug use as mechanisms to control and endanger their intimate partners (Lichtenstein 2005; Neundorfer et al.
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In these studies measuring the victims' perceptions of their partners' HIV risk behaviors, abused women report more high-risk behaviors among their partners than nonabused women (Garcia-Moreno et al.
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Data were collected from 1,275 males in 70 communities as part of a baseline assessment for a randomized controlled trial of the Stepping Stones HIV prevention program. The study found that perpetrators of violence are significantly more likely to engage in HIV risk behaviors, such as casual partners, transactional sex, use of drugs and alcohol, and non-IPV sexual assault, than nonperpetrators.
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2005) provide evidence that men who perpetrate violence against their intimate partners are also more likely to engage in HIV risk behaviors than men who do not perpetrate intimate partner violence.
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. Despite increasing attention being paid to how stress and immune function relate to IPV and HIV, no known research has investigated the hypotheses that an association exists between abuse and reduced immunity to HIV acquisition or that intimate partner violence might be associated with increased disease progression (reduction of CD4 levels)
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Future efforts should target multiple low- and middle-income countries where the AIDS epidemic is widespread or emerging so that the effects of culture and context on the ways that HIV/AIDS risk is increased by violence against women can be both better explicated and contextually understood. Implications for Prevention Given the evidence related to men's behavior, efforts to prevent HIV need to focus on the reduction of male use of violence against women as well as reduction of male HIV risk behaviors in intimate partnerships.
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2002. Physical health consequences of physical and psychological intimate partner violence.
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2007. Intimate partner violence prevalence and HIV risks among women receiving care in emergency departments: Implications for IPV and HIV screening.
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2006b. A cluster randomized-controlled trial to determine the effectiveness of Stepping Stones in preventing HIV infections and promoting safer sexual behaviour amongst youth in the rural Eastern Cape, South Africa: Trial design, methods and base line findings.
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2000. History of forced sex in association with drug use and sexual HIV risk behaviors, infection with STDs, and diagnostic medical care: results from the Young Women Survey.
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2003. Intimate partner violence and HIV risk among urban minority women in primary health care settings.
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