Determinants of post-disclosure violence among women living with HIV in sero-discordant unions in Kumasi, Ghana: a cross-sectional study

ABSTRACT

Violence against women is a global challenge with negative health outcomes. Women living with HIV (WLHIV) in sero-discordant unions are at risk of violence after disclosure of their status. This study assesses the risk factors for post-disclosure violence (PDV) against WLHIV in discordant unions in Kumasi, Ghana. A cross-sectional study was conducted among 129 consented WLHIV in discordant relationships in a tertiary facility from May to October 2017. Questionnaire data on socio-demographics and experience of PDV from partners were confidentially obtained. Logistic regression analysis was conducted to assess the independent associations of variables with PDV. PDV was experienced by 19.4% (n = 25) respondents; psychological violence was commonest (80%, n = 20). Women who experienced PDV were more likely to have had a forced first sexual intercourse (43.8% vs 15.9%; aOR 4.1, 95%CI: 1.4–12.4, p = 0.013), be financially independent of their spouses (42.9% vs 12.9%; aOR 0.2, 95%CI: 0.08–0.51, p = 0.001), had partners who interfered with their intake of antiretroviral therapy (50.0% vs 16.5%; aOR 5.1, 95%CI: 1.16–21.99, p = 0.031) or were in a polygamous relationship (63.0% vs 11.8%; aOR 12.8, 95%CI: 4.27–38.32, p < 0.001). The findings from this study indicate an urgent need for the integration of screening for partner violence (especially among WLHIV in discordant unions) and provision of the needed support into national HIV guidelines in Ghana.

KEYWORDS:

• women
• violence
• disclosure
• HIV positive
• sero-discordant sexual partners
• Ghana

Acknowledgements

The authors thank the participants, Professor Francis Agyemang Yeboah, Dr Rageshri Dhairyawan and Dr David Chadwick for their time and input.

Disclosure statement

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