Prenatal and Postnatal Intimate Partner Violence and Associated Factors Among HIV-Infected Women in Rural South Africa: A Longitudinal Study

Matseke, Motlagabo Gladys; Ruiter, Robert A. C.; Rodriguez, Violeta J.; Peltzer, Karl; Lee, Tae Kyoung; Jean, Jyh‐Chang; Sifunda, Sibusiso

doi:10.1177/1077801221992872

Cited by 4 publications

(2 citation statements)

References 58 publications

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“…11 , 16 In SSA, IPV prevalence ranges from 20% to 60% among pregnant/postpartum women living with HIV. 17 – 20 Considering global ambitions to eliminate vertical HIV transmissions by 2030, 21 the high rates of both prevalent and incident IPV among pregnant women living with HIV are particularly concerning. This is because pregnant women living with HIV reporting IPV are more likely not to adhere to ART thereby leading to unsuppressed viral load and subsequent elevated risk of vertical transmission.…”

Section: Introductionmentioning

confidence: 99%

The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi

Masiano

Tembo²,

et al. 2023

Therapeutic Advances in Infection

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Background: Intimate partner violence (IPV) is associated with suboptimal HIV treatment outcomes, but its distribution and risk factors among certain subpopulations of people living with HIV in resource-limited settings are not well known. We examined the prevalence, incidence, and recurrence of IPV and its association with adverse childhood experiences (ACEs) among pregnant/breastfeeding women living with HIV in Malawi. Methods: This study used longitudinal data for 455 pregnant women living with HIV continuously enrolled in the VITAL Start trial. IPV was assessed at baseline and months 1, 6, and 12 using the widely validated WHO IPV survey. Forms of IPV assessed were physical IPV, emotional IPV, and sexual IPV measured as prevalence, incidence, and recurrence. ACE histories were assessed using WHO’s ACE International Questionnaire (ACE-IQ) tool. Logistic and log-binomial regressions were used in multivariable analyses that controlled for factors such as depression and alcohol use. Results: Participants’ mean age was 27.6 ± 5.7 years. Forty-three percent (43%) reported IPV prevalence, 13% reported IPV incidence, and another 13% reported IPV recurrence, with emotional IPV being the most commonly reported IPV type. Over 96% reported experiencing ⩾1 ACE. In regression analysis, cumulative ACE scores were significantly associated with IPV prevalence and IPV recurrence and in both cases, the magnitude of association was greatest for sexual IPV compared with physical IPV and emotional IPV. ACE scores were not significantly associated with IPV incidence. Conclusions: IPV is highly prevalent among pregnant women living with HIV and continues to occur throughout the pregnancy and postpartum period; its graded relationship with ACEs is a concern in resource-limited settings where HIV/AIDS remains a public health concern. Strategies aimed to address the needs of pregnant/breastfeeding women living with HIV may benefit from the regular screening of this population for IPV and ACE, including in antenatal care clinics.

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Section: Introductionmentioning

confidence: 99%

The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi

Masiano

Tembo²,

et al. 2023

Therapeutic Advances in Infection

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“…A 2019 scoping review improved representation from African clinical samples and found that WLH who experienced VAW (as defined by the primary articles included in the review, including intimate partner violence or violence regardless of the perpetrator) were less likely to engage in HIV care and treatment, including ART uptake and adherence [ 14 ]. Clinical samples have confirmed these associations in African settings [ 15 , 16 , 17 ] but these are methodologically limited as participants are often actively engaged in healthcare.…”

Section: Introductionmentioning

confidence: 99%

Sexual violence and antiretroviral adherence among women of reproductive age in African population‐based surveys: the moderating role of the perinatal phase

et al. 2023

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Introduction Women face challenges in antiretroviral therapy (ART) adherence and achieving viral suppression despite progress in the expansion of HIV treatment. Evidence suggests that violence against women (VAW) is an important determinant of poor ART adherence in women living with HIV (WLH). In our study, we examine the association of sexual VAW and ART adherence among WLH and assess whether this association varies by whether women are pregnant/breastfeeding or not. Methods A pooled analysis was conducted among WLH from Population‐Based HIV Impact Assessment cross‐sectional surveys (2015−2018) from nine sub‐Saharan African countries. Logistic regression was used to examine the association between lifetime sexual violence and suboptimal ART adherence (≥1 missed day in the past 30 days) among reproductive age WLH on ART, and to assess whether there was any evidence for interaction by pregnancy/breastfeeding status, after adjusting for key confounders. Results A total of 5038 WLH on ART were included. Among all included women, the prevalence of sexual violence was 15.2% (95% confidence interval [CI]: 13.3%−17.1%) and the prevalence of suboptimal ART adherence was 19.8% (95% CI: 18.1%−21.5%). Among only pregnant and breastfeeding women, the prevalence of sexual violence was 13.1% (95% CI: 9.5%−16.8%) and the prevalence of suboptimal ART adherence was 20.1% (95% CI: 15.7%−24.5%). Among all included women, there was evidence for an association between sexual violence and suboptimal ART adherence (adjusted odds ratio [aOR]: 1.69, 95% CI: 1.25−2.28). There was evidence that the association between sexual violence and ART adherence varied by pregnant/breastfeeding status (p = 0.004). Pregnant and breastfeeding women with a history of sexual violence had higher odds of suboptimal ART adherence (aOR: 4.11, 95% CI: 2.13−7.92) compared to pregnant and breastfeeding women without a history of sexual violence, while among non‐pregnant and non‐breastfeeding women, this association was attenuated (aOR: 1.39, 95% CI: 1.00−1.93). Conclusions Sexual violence is associated with women's suboptimal ART adherence in sub‐Saharan Africa, with a greater effect among pregnant and breastfeeding WLH. To improve women's HIV outcomes and to achieve the elimination of vertical transmission of HIV, violence prevention efforts within maternity services and HIV care and treatment should be a policy priority.

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Multilevel determinants of physical violence among ever-partnered women in South Africa

Puoeng,

Tsawe

2024

Arch Womens Ment Health

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Background Violence against women continues to be a challenge in many countries. Many women suffer physical violence at the hands of their intimate partners and sometimes this leads to their deaths. This study aimed to examine the multilevel determinants of physical violence among ever-partnered women in South Africa. Methods We used data from the 2016 South Africa Demographic and Health Survey. The study has a weighted sample size of 4169 ever-partnered women aged 18–49 years, based on the domestic violence module. We included univariate, bivariate and multilevel logistic regression analysis. We included a two-level model to measure the relationship between the selected background characteristics and physical violence. Results The prevalence of physical violence among ever-partnered women was 20.6%. The bivariate findings showed that educational status, employment status, witness to inter-parental violence, partner’s drinking habits, household wealth, educational difference, and province were statistically associated with physical violence. The multilevel analysis showed some evidence of between-cluster variation in physical violence. We found that age, education, employment status, witness to inter-parental violence, partner’s drinking habits, household wealth, education difference, place of residence, and province were key predictors of physical violence. The odds of physical violence were more than two-fold in the Eastern Cape and Mpumalanga compared to Gauteng. Conclusion The study highlighted various key factors explaining physical violence. The findings suggest the need for targeted interventions aimed at specific communities of women, such as those from the Eastern Cape and Mpumalanga, as well as interventions that will empower women and address gender inequalities.

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Prenatal and Postnatal Intimate Partner Violence and Associated Factors Among HIV-Infected Women in Rural South Africa: A Longitudinal Study

Cited by 4 publications

References 58 publications

The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi

The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi

Sexual violence and antiretroviral adherence among women of reproductive age in African population‐based surveys: the moderating role of the perinatal phase

Multilevel determinants of physical violence among ever-partnered women in South Africa

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