Intimate partner violence polyvictimisation and HIV among coupled women in Zambia: Analysis of a population-based survey

ABSTRACT

Women in sub-Saharan Africa are disproportionately at risk for the dual epidemics of intimate partner violence (IPV) and HIV. Little is known about how specific violence profiles affect women’s HIV risk, limiting effective intervention. We analysed couples’ data from the Zambia Demographic and Health Survey 2013–2014 to evaluate relationships among IPV, male partner HIV status and women’s HIV status. We considered the individual and combined effects of physical, sexual, emotional, and high controlling behaviour violence and accumulated violence exposure, respectively. Among partnered women, 48.9% (n = 2,812) experienced IPV victimisation, of whom 52.1% (n = 1,465) reported polyvictimisation (experiencing two or more violence types). Female HIV prevalence was 13.2%. Adjusted for demographics, HIV was significantly higher for women who experienced three (17.3%, aPR 1.33, 95%CI: 1.04–1.69, p = 0.02) or four (22.1%, aPR 1.66, 95%CI: 1.23–2.26, p ≤ 0.01) types versus no IPV. Violence including emotional and/or high controlling victimisation was associated with female HIV infection (aPR: 1.31, 95%CI: 1.09–1.57, p = 0.01). Physical and/or sexual violence victimisation in the absence of other victimisation was not associated with HIV (aPR: 0.92, 95%CI:0.73–1.15, p = 0.46). IPV and HIV interventions are incomplete without addressing emotional and controlling IPV and the role of coercive relationship dynamics in transmission risk.

KEYWORDS:

• HIV
• IPV
• women
• Zambia
• polyvictimisation

Acknowledgements

We thank Dr. Keri Althoff for her input on the analysis plan.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability

Data used for this analysis are available from The DHS Program, https://dhsprogram.com/what-we-do/survey/survey-display-406.cfm

Additional information

Funding

This work was supported by National Institute of Mental Health of the National Institutes of Health: [grant numbers F31MH109378, F31MH11682101]; Johns Hopkins University Center for AIDS Research: [grant number 1P30AI094189].