Zembe Yanga Z, Townsend Loraine, Thorson Anna, Silberschmidt Margrethe, Ekstrom Anna Mia
Health Systems Research Unit, Medical Research Council of South Africa, Cape Town, South Africa.
Department of Public Health Sciences /Global health, Karolinska Institutet, and Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
PLoS One. 2015 Nov 23;10(11):e0139430. doi: 10.1371/journal.pone.0139430. eCollection 2015.
This paper aims to assess the extent and correlates of intimate partner violence (IPV), explore relationship power inequity and the role of sexual and social risk factors in the production of violence among young women aged 16-24 reporting more than one partner in the past three months in a peri-urban setting in the Western Cape, South Africa. Recent estimates suggest that every six hours a woman is killed by an intimate partner in South Africa, making IPV a leading public health problem in the country. While there is mounting evidence that levels of IPV are high in peri-urban settings in South Africa, not much is known about how it manifests among women who engage in concomitantly high HIV risk behaviours such as multiple sexual partnering, transactional sex and age mixing. We know even less about how such women negotiate power and control if exposed to violence in such sexual networks.
Two hundred and fifty nine women with multiple sexual partners, residing in a predominantly Black peri-urban community in the Western Cape, South Africa, were recruited into a bio-behavioural survey using Respondent Driven Sampling (RDS). After the survey, focus group discussions and individual interviews were conducted among young women and men to understand the underlying factors informing their risk behaviours and experiences of violence.
86% of the young women experienced IPV in the past 12 months. Sexual IPV was significantly correlated with sex with a man who was 5 years or older than the index female partner (OR 1.7, 95% CI 1.0-3.2) and transactional sex with most recent casual partner (OR 2.1, 95% CI 1.1-3.8). Predictably, women experienced high levels of relationship power inequity. However, they also identified areas in their controlling relationships where they shared decision making power.
Levels of IPV among young women with multiple sexual partners were much higher than what is reported among women in the general population and shown to be associated with sexual risk taking. Interventions targeting IPV need to address sexual risk taking as it heightens vulnerability to violence.
本文旨在评估亲密伴侣暴力（IPV）的程度及其相关因素，探讨关系中的权力不平等以及性和社会风险因素在南非西开普省一个城郊地区16至24岁、在过去三个月中有多个伴侣的年轻女性暴力行为产生过程中的作用。最近的估计表明，在南非，每六个小时就有一名女性被亲密伴侣杀害，这使得亲密伴侣暴力成为该国一个主要的公共卫生问题。虽然越来越多的证据表明南非城郊地区的亲密伴侣暴力水平很高，但对于在同时从事高风险艾滋病毒行为（如多个性伴侣、交易性行为和年龄混合）的女性中，这种暴力是如何表现的，我们所知甚少。对于这类女性如果在这种性网络中遭受暴力，她们如何协商权力和控制权，我们了解得更少。
采用应答驱动抽样（RDS）方法，在南非西开普省一个以黑人为主的城郊社区招募了259名有多个性伴侣的女性参与一项生物行为调查。调查结束后，对年轻女性和男性进行了焦点小组讨论和个人访谈，以了解影响他们风险行为和暴力经历的潜在因素。
86%的年轻女性在过去12个月中经历过亲密伴侣暴力。性方面的亲密伴侣暴力与与比主要女性伴侣大5岁或以上的男性发生性行为（比值比1.7，95%置信区间1.0 - 3.2）以及与最近的临时伴侣进行交易性行为（比值比2.1，95%置信区间1.1 - 3.8）显著相关。不出所料，女性经历了高水平的关系权力不平等。然而，她们也指出在其控制性关系中有一些她们共享决策权的领域。
有多个性伴侣的年轻女性中的亲密伴侣暴力水平远高于一般女性群体的报告水平，并且显示与性冒险行为有关。针对亲密伴侣暴力的干预措施需要解决性冒险行为问题，因为这会增加遭受暴力的脆弱性。
