Intimate partner violence in women living with HIV attending an inner city clinic in the UK: prevalence and associated factors

Abstract

ObjectivesStudies have shown high rates of intimate partner violence (IPV) in women living with HIV, but data from the UK are lacking. We aimed to estimate the prevalence of IPV and identify associated factors in women attending our inner London HIV clinic. MethodsWe conducted a cross-sectional study of women attending our HIV clinic in May to December 2011. Participants completed a standardized questionnaire and exposure to IPV was ascertained using a validated tool. Clinical data were collected from patient records. Logistic regression models were fitted to estimate adjusted odds ratios (AORs). ResultsThis analysis was based on 191 women with available data on IPV. The median age of women was 38 years (range 21-71 years); 74.1% were African-born Black. Over half (99 of 191; 52%) reported experiencing IPV in their lifetime, with 27 of 191 (14.1%) reporting IPV within the past year and 27 of 191 (14.1%) reporting it in pregnancy. Lifetime experience of IPV was associated with mental health problems [AOR 3.44; 95% confidence interval (CI) 1.24-9.57; P < 0.05] and 'other' Black (born outside sub-Saharan Africa) ethnicity (AOR 4.63; 95% CI 1.06-20.11; P < 0.05). We also found an association between older age and decreased likelihood of lifetime IPV (AOR 0.92; 95% CI 0.86-0.97; P < 0.05). ConclusionsOver half of the women in this study reported lifetime experience of IPV. We found associations between IPV and mental health problems, younger age and other Black ethnicity. In view of its high prevalence, we advocate greater awareness of IPV among HIV healthcare professionals and recommend universal screening.

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

“…The link between gender‐based violence and HIV is well established . As in the general population, women living with HIV may be at risk of intimate partner violence during pregnancy, with a lifetime prevalence rate of intimate partner violence in pregnancy estimated to be 14% in women living with HIV in the UK . We therefore fully endorse NICE antenatal guidelines recommending that all pregnant women be asked about domestic violence .…”

School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents

“…Poor health-related outcomes can result from lack of autonomy and difficulty in accessing services. Pregnancy coercion and birth control sabotage has been linked to unintended pregnancy (Miller 2010; Thiel de Bocanegra 2010), and limitations on condom use (Katz 2015), which increases the risk and incidence of sexually transmitted infections (STIs), including HIV (Dhairyawan 2013). It is also associated with poor perinatal and maternal health with increased risk of low birth weight and preterm birth (Shah 2010).…”

Domestic abuse

“…Nearly one in two female genitourinary medicine (GUM) clinic attendees report a lifetime experience of DA, almost twice that of the general female population 17. Similar rates are seen in HIV-positive women,18 with even higher rates seen in HIV-positive MSM 19…”