Relationship Power and Sexual Violence Among HIV-Positive Women in Rural Uganda

Conroy, Amy A.; Tsai, Alexander C.; Clark, Gina; Boum, Yap; Hatcher, Abigail M.; Kawuma, Annet; Hunt, Peter W.; Martin, Jeffrey N.; Bangsberg, David R.; Weiser, Sheri D.

doi:10.1007/s10461-016-1385-y

Cited by 19 publications

(22 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On average SRPS values for women in this study were consistent with studies of nondrug using women (Conroy et al, 2016; Muldoon et al, 2015), but lower than RC and DMD values reported in a study of drug-involved women (Campbell et al, 2012). Significant findings emerge that provide support for the importance of sexual relationship power dynamics in the context of sexual behaviors for WWID.…”

Section: Discussionsupporting

confidence: 88%

“…The SRPS has primarily been applied to nonsubstance using heterosexual partnerships in the field of HIV prevention research (Campbell et al, 2009; Conroy et al, 2016; Muldoon, Deering, Feng, Shoveller, & Shannon, 2015), in which lower SRPS scores have been associated with higher risk and inconsistent condom use and for HIV infection (Bonacquisti & Geller, 2013; Dunkle et al, 2004; Jewkes, Dunkle, Nduna, & Shai, 2010). However, we are unaware of any investigation of relationship dynamics in the intersecting injecting and sexual relationships of young WWID, or one that quantifies the impact of sexual relationship power on injecting or sexual risk behaviors in the context of WWID’s sexual relationships.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

Morris

Montgomery

Briceño

et al. 2017

Substance Use & Misuse

View full text Add to dashboard Cite

Background To date, research applying the Sexual Relationship Power Scale (SRPS) has been limited to sexual risk behaviors. Objective We measured levels of sexual relationship power and examined associations between sexual relationship power and injecting and sexual behaviors that place women at increased risk for blood borne infections. Methods Using data from a cross-sectional study of young women who inject drugs (WWID) in San Francisco, USA, logistic regression analysis identified independent associations between SRPS and subscale scores (relationship control [RC] and decision making dominance [DMD]) and injecting and sexual behaviors. Results Of the 68 young WWID, 24 (34%) reported receptive syringe sharing, 38 (56%) reused/shared a cooker to prepare drugs, and 25 (37%) injected someone else’s drug residue during the three-months prior to enrollment. Most (60, 88%) reported condomless sex with main sex-partner, 8 (12%) reported transactional sex, and 36 (53%) had two or more recent sex partners. The median SRPS score was 2.98 (IQR: 2.65, 3.18), 3.23 (IQR: 3.23, 3.57) for RC and 2.40 (IQR: 2.20, 2.60) for DMD. No significant associations were detected between SRPS or DMD and injecting or sexual risk behaviors. After adjusting for gender and years injecting, for every one-point increase in RC, women had a 6.70 lower odds of recent condomless sex (95% CI: 0.92, 50.00, p = 0.06), and a 3.90 lower odds of recent transactional sex (95%CI: 1.22, 12.50, p = 0.02). Conclusion Our study findings suggest that some components of sexual relationship power may play a role in sexual risk, but not in injecting risk.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

Morris

Montgomery

Briceño

et al. 2017

Substance Use & Misuse

View full text Add to dashboard Cite

show abstract

“…41 Other studies have, in turn, found that relationship power inequities are determinants of HIV transmission risk. 42,43 In order to comprehensively address HIV disclosure concerns among women, future research is needed to understand the role of community norms in influencing relationship power inequities and risky sex.…”

Section: Discussionmentioning

confidence: 99%

Community-Level HIV Stigma as a Driver for HIV Transmission Risk Behaviors and Sexually Transmitted Diseases in Sierra Leone: A Population-Based Study

Kelly

Reid

Lahiff

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

Introduction While HIV stigma has been identified as an important risk factor for HIV transmission risk behaviors, little is known about the contribution of community-level HIV stigma to HIV transmission risk behaviors and self-reported sexually transmitted diseases (STDs), or how gender may modify associations. Methods We pooled data from the 2008 and 2013 Sierra Leone DHS. For HIV stigma, we examined HIV stigmatizing attitudes and HIV disclosure concerns at both individual and community levels. Outcomes of HIV transmission risk behaviors were recent condom usage, consistent condom usage, and self-reported STDs. We assessed associations with multivariable logistic regressions. We also analyzed gender as an effect modifier of these associations. Results 24,030 (69.5%) of 34,574 respondents who had heard of HIV were included in this analysis. Community-level HIV stigmatizing attitudes and disclosure concerns were associated with higher odds of self-reported STDs, respectively (AOR=2.07; 95%CI, 1.55–2.77; AOR=2.95; 95%CI, 1.51–5.58). Compared to men, community-level HIV stigmatizing attitudes among women were a stronger driver of self-reported STDs (interaction p=0.07). Gender modified the association between community-level HIV disclosure concerns and both recent and consistent condom usage (interaction p=0.03 and p=0.002, respectively). Community-level HIV disclosure concerns among women were observed to be a driver of risky sex and self-reported STDs. Conclusions This study shows that community-level HIV stigma may be a driver for risky sex and self-reported STDs, particularly among women. Our findings suggest that community-held stigmatizing beliefs and HIV disclosure concerns among women might be important targets for HIV stigma reduction interventions.

show abstract

“…It has been widely shown that alcohol is a risk factor for sexual violence and viceversa [10,11,37,38,67]. Alcohol may cause aggressive behaviors as a result of a distortion in the perceptions or of a disinhibition [6], it can also make it more difficult for the victims to protect themselves or it can even bring the victims to places where they have a greater risk of meeting a potential offender [3,9,68–70]. It is a relevant aspect to be considered in sexual violence prevention and in HIV VCT for adults and young people in the DRC, where a high percentage of adolescents both use alcohol and are sexually active [9].…”

Section: Discussionmentioning

confidence: 99%

Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC)

Burgueño¹,

Carlos

Burgo

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

IntroductionSexual violence, an HIV determinant, is an integrated behavior in the D.R.Congo. We aimed to analyze the prevalence of forced sexual intercourse (FSI) among people receiving HIV Voluntary Counseling and Testing in a hospital in Kinshasa, and its association with socio-demographics, behaviors and HIV status.MethodologyCase-control study (2010–2012). Two-hundred and seventy-four cases with a new HIV+ test and 1,340 controls with an HIV- test were interviewed about HIV-related knowledge, attitudes and behaviors, including FSI.ResultsThirty-four percent of the participants declared having had FSI (38% of women and 32% of men). Being a woman, aged 25–49 and reporting multiple sexual partners were associated with reporting FSI. For men, being single was protective against FSI; and cohabiting, having a high socioeconomic status, and alcohol consumption increased the odds. For women, being single, divorced/separated and widow was associated with reporting FSI. A significant positive association was found between FSI and an HIV positive test.ConclusionAmong our Congolese population, FSI was strongly associated with HIV infection and it was also associated with alcohol consumption and multiple sexual partnerships, other key HIV determinants. These behaviors need to be identified as potential risk factors of FSI during counseling interventions. Researchers, practitioners and decision-makers should work together to get violence prevention integrated into health, social and educational policies.

show abstract

Relationship Power and Sexual Violence Among HIV-Positive Women in Rural Uganda

Cited by 19 publications

References 73 publications

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

A Study of Sexual Relationship Power among Young Women Who Inject Drugs and Their Sexual Partners

Community-Level HIV Stigma as a Driver for HIV Transmission Risk Behaviors and Sexually Transmitted Diseases in Sierra Leone: A Population-Based Study

Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC)

Contact Info

Product

Resources

About