TY - JOUR
T1 - Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda
AU - Shuaib, Faisal M.B.
AU - Ehiri, John E.
AU - Jolly, Pauline
AU - Zhang, Qionghui
AU - Emusu, Donath
AU - Ngu, Julius
AU - Foushee, Herman
AU - Katongole, Drake
AU - Kirby, Russell
AU - Wabwire-Mangen, Fred
N1 - Funding Information:
We gratefully acknowledge the support of Makerere University School of Public Health, and the AIDS Information Centers in Kampala, Jinja and Mbale, Uganda. Financial support for this study was provided by the Fogarty International Center (FIC) of the US National Institutes of Health (Award R25TW007501). FIC/NIH did not participate in any way in the conceptualization and conduct of the research, or in the drafting of the manuscript for this article.
PY - 2012/6
Y1 - 2012/6
N2 - HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in nega tive concordant unions. Multivariable logistic regression was used to assess the association between participants ' serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1 ± 11.1 years, range: 19 - 65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2 ± 9.0 years, range: 18 - 56 years), or HIV negative women in concordant relationships (32.3 ± 11.0 years, range: 18 - 62), (p = 0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95 % CI 1.27 - 4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples ' HIV serostatus was not significant related to incident sexual violence after controlling for potential confounding covariates. Nevertheless, the results were able to elucidate the sexual violence risk factor profile of participants based on couples ' HIV serostatus. Couple counseling protocols at HIV voluntary counseling and testing centers in Uganda should identify those at risk for sexual violence and develop interventions to reduce its incidence.
AB - HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in nega tive concordant unions. Multivariable logistic regression was used to assess the association between participants ' serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1 ± 11.1 years, range: 19 - 65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2 ± 9.0 years, range: 18 - 56 years), or HIV negative women in concordant relationships (32.3 ± 11.0 years, range: 18 - 62), (p = 0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95 % CI 1.27 - 4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples ' HIV serostatus was not significant related to incident sexual violence after controlling for potential confounding covariates. Nevertheless, the results were able to elucidate the sexual violence risk factor profile of participants based on couples ' HIV serostatus. Couple counseling protocols at HIV voluntary counseling and testing centers in Uganda should identify those at risk for sexual violence and develop interventions to reduce its incidence.
KW - Gender and health
KW - Gender-based violence
KW - HIV/AIDS
KW - Sexual violence
KW - Sub-Saharan Africa
KW - Uganda
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U2 - 10.1515/IJAMH.2012.019
DO - 10.1515/IJAMH.2012.019
M3 - Article
C2 - 22909921
AN - SCOPUS:84867613934
SN - 0334-0139
VL - 24
SP - 125
EP - 133
JO - International Journal of Adolescent Medicine and Health
JF - International Journal of Adolescent Medicine and Health
IS - 2
ER -