Typologies of violence against women in Brazil: A latent class analysis of how violence and HIV intersect

ABSTRACT

We address the limited understanding around the overlap between violence and HIV in Brazil. Data was from two clinic-based samples of HIV-positive (n = 1534) and HIV-negative women (n = 1589) in São Paulo and Porto Alegre. We conducted latent class analysis and identified violence typologies by type of violence, life course timing, frequency, and perpetrator, stratified by city and HIV-status. Overall, HIV-positive women experienced more lifetime physical and sexual violence than HIV-negative women. Twelve unique violence latent classes were identified. In São Paulo, HIV-positive women were likely to have endured physical violence several times (Conditional Probability [CP]: 0.80) by an intimate partner (CP: 0.85), and sexual violence several times (CP: 0.46) by an intimate partner (CP: 0.62). In Porto Alegre, HIV-positive women endured physical violence several times (CP: 0.80) by an intimate partner (CP: 0.70) during childhood/adolescence (CP: 0.48), and sexual violence several times (CP: 0.54) by an intimate partner (CP: 0.60). Findings inform interventions to educate around gender equity, violence, and the health effects of violence including HIV, integrate HIV and violence services, and improve the provision of bio-medical HIV prevention among HIV-negative women who experience violence.

KEYWORDS:

• HIV
• violence
• gender
• Brazil
• latent class analysis

Acknowledgements

This research was supported by the World Bank/Sexual Violence Research Initiative (SVRI) Development Marketplace for Innovation in Prevention of Gender-Based Violence (PI: Stockman and Barbosa, Co-I: Tsuyuki and Knauth). The original research, which collected the data, was funded by the National Scientific and Technological Development Council (CNPq) in Porto Alegre (PI: D. Knauth; Process no. 478174/2009-8; MCT/CNPq 14/2009). Research in São Paulo was funded by SP Fapesp (PI: Barbosa; 2012/25239-3), CNPq (PI: Barbosa; 580; 471892/2011-4; 4718296/2012-6), and the United Nations Fund for Population Activities Pan American Health Organization (PI: Barbosa; BR/LOA/1200041.001/002). Kiyomi Tsuyuki was supported by NIDA (T32 DA023356); NICHD (R01 HD077891-04S1); and NIAAA (K01AA025009). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

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

Additional information

Funding

This research was supported by the World Bank/Sexual Violence Research Initiative (SVRI) Development Marketplace for Innovation in Prevention of Gender-Based Violence (PI: Stockman and Barbosa, Co-I: Tsuyuki and Knauth). The original research, which collected the data, was funded by the National Scientific and Technological Development Council (CNPq) in Porto Alegre (PI: D. Knauth; Process no. 478174/2009-8; MCT/CNPq 14/2009). Research in São Paulo was funded by SP Fapesp (PI: Barbosa; 2012/25239-3), CNPq (PI: Barbosa; 580; 471892/2011-4; 478296/2012-6), and the United Nations Fund for Population Activities Pan American Health Organization (PI: Barbosa; BR/LOA/1200041.001/002). Kiyomi Tsuyuki was supported by NIDA (T32 DA023356); NICHD (R01 HD077891-04S1); and NIAAA (K01AA025009).