A Systematic Review of the Relationships between Intimate Partner Violence and HIV/AIDS

Kouyoumdjian, Fiona G.; Findlay, Nicole; Schwandt, Michael; Calzavara, Liviana

doi:10.1371/journal.pone.0081044

Cited by 109 publications

(105 citation statements)

References 94 publications

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“…A growing body of evidence shows that the HIV epidemic and the IPV burden overlap geographically. A systematic review showed that 10 studies from different regions of the world (East Africa, India, Papua New Guinea, the US, and Mexico) reported high prevalence rates of HIV in women exposed to IPV, and that HIV-infected women were more likely to have experienced multiple forms of IPV than HIVuninfected women (Kouyoumdjian et al, 2013).…”

Section: What Is the Geographical Overlap Between Ipv And Hiv?mentioning

confidence: 99%

“…A second recent systematic review examined the relationship between IPV and HIV, exploring the mechanisms behind this relationship (Kouyoumdjian et al, 2013). A synthesis of these findings is presented below.…”

Section: What Are the Mechanisms Driving This Association?mentioning

confidence: 99%

“…The first is that sexual IPV may increase the risk of HIV infection through trauma to the vaginal or rectal mucosa. Qualitative studies describe this anecdotally (Lichtenstein, 2005), but there is a lack of quantitative evidence to support this hypothesis (Kouyoumdjian et al, 2013).…”

Section: Ipv As the Antecedentmentioning

confidence: 99%

“…Four potential pathways describing how the risk could be reversed, with HIV triggering IPV, are presented in the review by Kouyoumdjian et al (2013). First, IPV might be a consequence of HIV disclosure; while there is some evidence to support this, quantitative studies tend to conclude that violence after disclosure is infrequent (Kiarie et al, 2006;Kissinger et al, 2003).…”

Section: Hiv As the Antecedentmentioning

confidence: 99%

“…While existing literature has focused on the relationship of IPV to either CMD (Golding, 1999;Howard et al, 2010;Lipsky & Caetano, 2007) or to HIV (Kouyoumdjian, Findlay, Schwandt, & Calzavara, 2013;Siemieniuk, Krentz, & Gill, 2013;WHO, 2004), the evidence is less robust for the connections between IPV and HIV, while considering CMD. In low-and middle-income countries (LMICs) with limited resources where integrated programming has the potential to reduce delivery costs, it is important to better understand the inter-relationship between IPV, HIV, and CMD.…”

Section: Introductionmentioning

confidence: 99%

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Intimate partner violence, HIV, and mental health: a triple epidemic of global proportions

Mitchell

Wight

Heerden

et al. 2016

International Review of Psychiatry

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Intimate partner violence (IPV) is a global health problem of epidemic proportions, affecting a third of women across the globe and as many as 60% in heavily affected regions of Africa. There is strong evidence that risk of IPV is heightened in HIV-infected women, and emerging evidence linking experiencing IPV and/or HIV to a higher likelihood of experiencing mental health problems. This triple burden makes women in Africa, living in the epicentre of HIV, all the more vulnerable. In this synthesis, this study reviewed literature pertaining to the overlap of IPV, HIV, and mental health problems. It presents a series of geographical maps illustrating the heavy burden of IPV and HIV globally, and how these coincide with a growing prevalence of mental health problems in Africa. Furthermore, it presents evidence on: the association between IPV and HIV, shared risk factors, and health consequences. This synthesis sheds light on the fact that $30% of women are affected by these three burdens concurrently, and the need for intervention is essential. Promising large scale interventions which have taken place in Africa are described, and evidence is presented in support of integrated versus targeted screening. ARTICLE HISTORY

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Section: What Is the Geographical Overlap Between Ipv And Hiv?mentioning

confidence: 99%

Section: What Are the Mechanisms Driving This Association?mentioning

confidence: 99%

Section: Ipv As the Antecedentmentioning

confidence: 99%

Section: Hiv As the Antecedentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intimate partner violence, HIV, and mental health: a triple epidemic of global proportions

Mitchell

Wight

Heerden

et al. 2016

International Review of Psychiatry

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Conditional cash transfers and the reduction in partner violence for young women: an investigation of causal pathways using evidence from a randomized experiment in South Africa (HPTN 068)

et al. 2018

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IntroductionEvidence has shown that the experience of violence by a partner has important influences on women's risk of HIV acquisition. Using a randomized experiment in northeast South Africa, we found that a conditional cash transfer (CCT) targeted to poor girls in high school reduced the risk of physical intimate partner violence (IPV) in the past 12 months by 34%. The purpose of this analysis is to understand the pathways through which the CCT affects IPV.MethodsHPTN 068 was a phase 3, randomized controlled trial in rural Mpumalanga province, South Africa. Eligible young women (aged 13–20) and their parents or guardians were randomly assigned (1:1) to either receive a monthly cash transfer conditional on monthly high school attendance or no cash transfer. Between 2011 and 2015, participants (N = 2,448) were interviewed at baseline, then at annual follow‐up visits at 12, 24 and 36 months. The total effect of the CCT on IPV was estimated using a GEE log‐binomial regression model. We then estimated controlled direct effects to examine mediation of direct effects through intermediate pathways. Mediators include sexual partnership measures, the sexual relationship power scale, and household consumption measures.ResultsWe found evidence that the CCT works in part through delaying sexual debut or reducing the number of sexual partners. The intervention interacts with these mediators leading to larger reductions in IPV risk compared to the total effect of the CCT on any physical IPV [RR 0.66, CI(95%):0.59–0.74]. The largest reductions are seen when we estimate the controlled direct effect under no sexual debut [RR 0.57, CI(95%):0.48–0.65] or under no sexual partner in the last 12 months [RR 0.53, CI(95%):0.46–0.60].ConclusionsResults indicate that a CCT for high school girls has protective effects on their experience of IPV and that the effect is due in part to girls choosing not to engage in sexual partnerships, thereby reducing the opportunity for IPV. As a lower exposure to IPV and safer sexual behaviours also protect against HIV acquisition, this study adds to the growing body of evidence on how cash transfers may reduce young women's HIV risk.

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A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

et al. 2019

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Introduction Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV‐negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. Methods We conducted a cohort study with WLHIV in three Canadian provinces. Recent violence was assessed through self‐reported experiences of control, physical, sexual or verbal abuse in the past three months. At Time 1 (2013‐2015) three forms of stigma were assessed (HIV‐related, racial, gender) and at Time 2 (2015‐2017) only HIV‐related stigma was assessed. We conducted structural equation modelling (SEM) using the maximum likelihood estimation method with Time 1 data to identify direct and indirect effects of gender discrimination, racial discrimination and HIV‐related stigma on depression via recent violence. We then conducted mixed effects regression and SEM using Time 1 and Time 2 data to examine associations between HIV‐related stigma, recent violence and depression. Results At Time 1 (n = 1296), the direct path from HIV‐related stigma (direct effect: β = 0.200, p < 0.001; indirect effect: β = 0.014, p < 0.05) to depression was significant; recent violence accounted for 6.5% of the total effect. Gender discrimination had a significant direct and indirect effect on depression (direct effect: β = 0.167, p < 0.001; indirect effect: β = 0.050, p < 0.001); recent violence explained 23.15% of the total effect. Including Time 1 and Time 2 data (n = 1161), mixed‐effects regression results indicate a positive relationship over time between HIV‐related stigma and depression (Acoef: 0.04, 95% CI: 0.03, 0.06, p < 0.001), and recent violence and depression (Acoef: 1.95, 95% CI: 0.29, 4.42, p < 0.05), controlling for socio‐demographics. There was a significant interaction between HIV‐related stigma and recent violence with depression (Acoef: 0.04, 95% CI: 0.01, 0.07, p < 0.05). SEM analyses reveal that HIV‐related stigma had a significant direct and indirect effect on depression over time (direct effect: β = 0.178, p < 0.001; indirect effect: β = 0.040, p < 0.001); recent violence experiences accounted for 51% of the total effect. Conclusions Our findings suggest that HIV‐related stigma is associated with increased experiences of recent violence, and both stigma and violence are associated with increased depression among WLHIV in Canada. There is an urgent need for trauma‐informed stigma interventions to address stigma, discrimination and violence.

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A Systematic Review of the Relationships between Intimate Partner Violence and HIV/AIDS

Cited by 109 publications

References 94 publications

Intimate partner violence, HIV, and mental health: a triple epidemic of global proportions

Intimate partner violence, HIV, and mental health: a triple epidemic of global proportions

Conditional cash transfers and the reduction in partner violence for young women: an investigation of causal pathways using evidence from a randomized experiment in South Africa (HPTN 068)

A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

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