Intimate Partner Violence and the CDC's Best‐Evidence HIV Risk Reduction Interventions

Abstract

Justification for IPV integration in HIV risk reduction programs is explored and supported by evidence-based research and practice.

Mitigating intimate partner violence to promote safe linkage to care for South African women who test HIV positive during mobile counseling and testing.

“…Financial constraints additionally prevent women from having the means to flee the relationship (Hale & Vazquez, 2011). Personal violence also occurs related to the general cycle of escalating violence in certain types of IPV relationships (Gielen, McDonnell, Burke, & O'Campo, 2000;WHO, 2012), and upon disclosure of an HIV+ serostatus to one's partner (Prowse et al, 2013;Mkandawire-Vahlmu, Stevens, Kako & Dressel, 2013), often due to the social stigma of the diagnosis (Myer, Rebe & Morroni, 2007). An exploratory study in sub-Saharan Africa cited that IPV against women with HIV frequently follows the scenario of a man coming home drunk and becoming enraged when either the woman notifies him of her seropositive status or she refuses to have sex with him (Murray et al as cited in Hale & Vazquez, 2011).…”

“…Rather, many women with HIV diagnoses have already been experiencing IPV in their relationship. Thus, the pathway between HIV and IPV is multidirectional (see figure 1.2); IPV increases the risk for HIV transmission, and living with HIV increases the risk for [further] IPV in various forms (Ball, 2013;Dunkle et al 2004;Hale & Vazquez, 2011;Jewkes, Sikweyiya, Morrell, & Dunkle, 2011;Maman, Yamanis, Kouyoumdjian, Watt, & Mbwambo, 2010;Prowse, Logue, Fantasia, & Sutherland, 2013;CDC, 2014;Ramachandran, Yonas, Silvestre, & Burke, 2010;Ball, 2013;Shi, Kouyoumdjian, & Dushoff, 2013).…”

“…Other studies have shown a correlation between HIV transmission and other risk factors related to IPV (Shai et al). For example, coercion in a relationship can reduce a woman's ability to protect herself Shi et al;Dunkle & Decker, 2012;Prowse et al, 2013), or negotiate safer sex (Shi et al;UNAIDS, 2013b) as it may not be safe for her to discuss condom use (Dunkle & Decker). Regardless of the mode of transmission, women living with HIV are more likely to already be experiencing IPV and the diagnosis has been shown to foment further aggression (Prowse et al, 2013).…”

“…For example, coercion in a relationship can reduce a woman's ability to protect herself Shi et al;Dunkle & Decker, 2012;Prowse et al, 2013), or negotiate safer sex (Shi et al;UNAIDS, 2013b) as it may not be safe for her to discuss condom use (Dunkle & Decker). Regardless of the mode of transmission, women living with HIV are more likely to already be experiencing IPV and the diagnosis has been shown to foment further aggression (Prowse et al, 2013). Cultural and structural violence is experienced by women living with HIV, where women are often blamed for the IPV and then pressured by family and society to stay in the relationship.…”

“…The majority of individuals who receive HIV testing either face subsequent delays to entry to care or are lost to follow-up at some point in the HIV treatment continuum (Christopulous et al, 2013). A portion of this attrition is attributed to the HIV-IPV link (Abramsky et al, 2012;Adams et al, 2011;CDC, 2014;Mkandawire-Vahlmu et al 2013;Prowse, Logue, Fantasia, & Sutherland 2013;WHO, n.d), as women with both HIV and IPV face one of the heaviest burdens of care (Hale & Vazquez, 2011). One study found 16-51% of individuals reported fear of IPV as a substantial barrier to HIV disclosure (Medley, Garcia-Moreno, McGill & Maman, 2004;WHO, n.d.).…”