Association Between Domestic Violence and HIV Serostatus Among Married and Formerly Married Women in Kenya

Abstract

The prevalence of both domestic violence (DV) and HIV among Kenyan women is known to be high, but the relationship between them is unknown. Nationally representative cross-sectional data from married and formerly married (MFM) women responding to the Kenya Demographic and Health Survey 2008/2009 were analyzed adjusting for complex survey design. Multivariable logistic regressions were used to assess the covariate-adjusted associations between HIV serostatus and any reported DV as well as four constituent DV measures: physical, emotional, sexual, and aggravated bodily harm, adjusting for co-variates entered into each model using a forward stepwise selection process. Co-variates of a priori interest included those representing marriage history, risky sexual behavior, substance use, perceived HIV risk, and socio-demographic characteristics. The prevalence of HIV among MFM women was 10.7% (any DV: 13.1%, no DV: 8.6%); overall prevalence of DV was 43.4%. Among all DV measures, only physical DV was associated with HIV (11.9%; adjusted odds ratio: 2.01, p < 0.05). Efforts by the government and women's groups to monitor and improve policies to reduce DV, such as the Sexual Offences Act of 2006, are urgently needed to curb HIV, as are policies that seek to provide DV counseling and treatment to MFM women.

Types and risk factors of violence experienced by people living with HIV, Pakistan: a cross-sectional study

“…The prevalence of sexual violence was 74.8% in our study, a figure much higher than reported from developed and developing countries (20,23,31,32). A meta-analysis in the United States of America showed the prevalence of intimate partner violence was 55.3% in HIV-positive women, and 30% of these women had experienced posttraumatic stress disorder (32).…”

A phenomenological study of the experience of domestic violence in Iranian women with HIV

“…In this study, control over the participants' lives even included personal tasks such as medication and self-care behaviours so that some husbands prevented their wives from receiving care and adhering to medication, and this might impair women's health and contribute to disease progression. Previous studies have revealed that men's interference with women's health care is one of the manifestations of violence against HIV-infected women (Lichtenstein, 2006;Kouyoumdjian et al, 2013) and the adverse consequences of violence are worse in these women due to their lack of access to medical care (Onsomu et al, 2015).…”

Gendered differences in the perceived risks and benefits of oral PrEP among HIV-serodiscordant couples in Kenya

“…T. Montgomery et al, 2012). Findings from the parent study cohort, published elsewhere (Ngure et al, 2014), reveal a similar dynamic in childbearing decisions; when men wanted a child but their wives did not, they used language such as “she must” and “I will force her.” Such intense divisions of power have been known to result in domestic violence against women (Pintye et al, 2015; Wingood & DiClemente, 2000), and HIV seropositive women are at higher risk of such abuse than their seronegative peers in both Kenya (Fonck et al, 2005; Onsomu et al, 2014) and Uganda (Emusu et al, 2009; Were et al, 2011). These patterns provide a possible explanation for why the seropositive men in this study were vocal about their control of household decisions and silent about the potential for taking PrEP to be burdensome to their spouses: they may experience their HIV diagnosis as a loss of masculine control, which they are subsequently attempting to re-establish in their homes.…”