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Diagnosis and Disclosure of HIV Status: Implications for Women's Risk of Physical Partner Violence in the Postpartum Period.

作者信息

Maman Suzanne, Groves Allison K, McNaughton Reyes H Luz, Moodley Dhayendre

机构信息

*Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; †Center on Health, Risk and Society, American University, Washington, DC; and ‡Department of Obstetrics and Gynaecology, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.

出版信息

J Acquir Immune Defic Syndr. 2016 Aug 15;72(5):546-51. doi: 10.1097/QAI.0000000000001012.


DOI:10.1097/QAI.0000000000001012
PMID:27028499
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4942348/
Abstract

INTRODUCTION: This study prospectively examined whether HIV leads to elevated risk for intimate partner violence (IPV) for women and how this risk varies depending on HIV status disclosure to a partner. METHODS: We ran a series of logistic regression models using data from 1092 pregnant and postpartum women enrolled in an RCT in Durban, South Africa. Model 1 assessed whether baseline HIV status predicted 14-week postpartum physical IPV, controlling for baseline physical IPV, disclosure to partner, and demographic and study covariates. Model 2 added the interaction between HIV status and disclosure. RESULTS: HIV was not associated with 14-week physical IPV in the main effects model [adjusted odds ratio: 1.34, 95% confidence interval (CI): 0.88 to 2.05]. However, there was a statistically significant positive interaction between HIV and disclosure (adjusted odds ratio: 0.22, 95% CI: 0.05 to 0.96). Among women who disclosed their HIV status, HIV was not significantly associated with 14-week IPV (adjusted odds ratio: 1.12, 95% CI: 0.71 to 1.89). However, among women who had not disclosed, the odds of reporting IPV at 14 weeks was 5.15 times higher for HIV-positive women as compared with HIV-negative women (95% CI: 1.25 to 21.00). DISCUSSION: Although we established that HIV does not increase incidence of IPV for all HIV-positive women, we found an elevated risk of IPV among the HIV-positive women who chose not to disclose their status to their partner. Nondisclosure is likely a marker for other problematic aspects of the relationship, and counselors should either find alternative safe options for disclosure or support women's decisions not to disclose.

摘要

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[1]
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[7]
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[8]
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本文引用的文献

[1]
Exploring risk of experiencing intimate partner violence after HIV infection: a qualitative study among women with HIV attending postnatal services in Swaziland.

BMJ Open. 2015-5-14

[2]
Intimate partner violence and HIV in ten sub-Saharan African countries: what do the Demographic and Health Surveys tell us?

Lancet Glob Health. 2014-11-21

[3]
Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission.

J Int AIDS Soc. 2014-11-3

[4]
Efficacy of enhanced HIV counseling for risk reduction during pregnancy and in the postpartum period: a randomized controlled trial.

PLoS One. 2014-5-13

[5]
Intimate partner violence and HIV infection among women: a systematic review and meta-analysis.

J Int AIDS Soc. 2014-2-13

[6]
A systematic review of the relationships between intimate partner violence and HIV/AIDS.

PLoS One. 2013-11-25

[7]
Intimate partner violence is associated with incident HIV infection in women in Uganda.

AIDS. 2013-5-15

[8]
The clinical implications of high rates of intimate partner violence against HIV-positive women.

J Acquir Immune Defic Syndr. 2013-9-1

[9]
A prospective study of frequency and correlates of intimate partner violence among African heterosexual HIV serodiscordant couples.

AIDS. 2011-10-23

[10]
What factors are associated with recent intimate partner violence? findings from the WHO multi-country study on women's health and domestic violence.

BMC Public Health. 2011-2-16

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