Psychological and physical intimate partner violence and sexual risk behavior among South African couples: a dyadic analysis

ABSTRACT

This study aimed to examine intimate partner violence (IPV) as it relates to both partners’ perceptions of IPV and sexual behaviors, considering how their IPV might be interdependent within the relationship dynamics. The sample consisted of 713 female–male dyads in which women were pregnant and living with HIV in rural South Africa. Using an actor-partner interdependence model (APIM), we examined the interdependent influence of psychological and physical IPV on men by their female partners and psychological and physical IPV on women by their male partners on sexual risk behavior. The APIM model found there were no actor (b = −0.06, SE = 0.05, p = .221) or partner (b = −1.2, SE = 0.06, p = .056) effects contributing to protected sex by female IPV victimization. In contrast, significant actor (b = −0.28, SE = 0.06, p < .001) and partner (b = −0.29, SE = 0.06, p < .001) effects for protection were related to male IPV victimization. The model also found that the covariate of female HIV disclosure was associated with both male (b = 0.5, SE = 0.12, p < .001) and female protected sexual intercourse (b = 0.58, SE = 0.1, p < .001). Female HIV disclosure was related to an increased likelihood of protected sex by both male and female partners. As male partners reported more IPV victimization, the likelihood of protected sex between male and female partners decreased.Trial registration: ClinicalTrials.gov identifier: NCT02085356.

KEYWORDS:

• Intimate partner violence
• HIV disclosure
• protected sex
• HIV-infected pregnant women
• South Africa

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

Prior to study onset, ethical approval was obtained from the Mpumalanga Department of Health, the Human Sciences Research Council (HSRC) and the University of Miami (UM) Institutional Review Board. Ethical approval for the study was procured from the Human Sciences Research Council (HSRC) Research Ethics Committee (REC) (Number: REC4/21/08/13), the Department of Health and Welfare, Mpumalanga Provincial Government, and the University of Miami Miller School of Medicine Institutional Review Board (IRB ID: 20130238). The study was registered as a clinical trial on clinicaltrials.gov, Number NCT02085356.

Human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

This study was funded by National Institutes of Health (NIH), R01HD078187, and with the support of the University of Miami Miller School of Medicine Center for AIDS Research, NIH, P30AI073961.