The University of North Carolina at Chapel Hill, USA.
Boston University School of Medicine, MA, USA.
J Interpers Violence. 2020 Nov;35(23-24):5905-5925. doi: 10.1177/0886260517724834. Epub 2017 Aug 14.
Although the prevalence of intimate partner violence (IPV) in Southeast Asia is one of the highest in the world, IPV remains understudied in the region, especially among women living with HIV (WLWH). This study aims to understand how gender and violence norms influence how WLWH interpret and prioritize violence as a health issue. We also explore whether HIV disclosure was seen as a trigger for IPV. We conducted in-depth interviews with 20 WLWH (median age = 35.5 years; range = 28-54 years) in northern Vietnam. Participants were recruited from an outpatient antiretroviral treatment (ART) clinic. Semi-structured interviews were transcribed, translated, and analyzed to identify themes using a gender-focused theoretical framework. Twelve participants reported experiencing IPV by their current or former husbands, most of which occurred before their HIV diagnoses. Only one participant felt her HIV status was a factor for the IPV she experienced; the remaining participants did not explicitly link IPV and HIV. None expressed fear or experience of IPV after disclosing to their husbands. When asked about a woman's role in society, the majority spoke about the responsibility to build family harmony by doing housework, raising children, making a steady income, and being faithful to her husband. Participants viewed marital conflict as the woman's problem to avoid by acting docile or to resolve peacefully by bearing violence quietly. Almost all reported contracting HIV from their husbands. Regardless of whether their children were infected ( = 8) or not ( = 10), participants spoke about being compelled to initiate and adhere to ART to care for their children emotionally and financially. In the context of Vietnamese gender norms, participants expressed low urgency for help-seeking after experiencing IPV and high urgency for help-seeking after being diagnosed with HIV. Multilevel interventions are needed to shift social norms around acceptability of IPV.
尽管东南亚的亲密伴侣暴力（IPV）患病率是世界上最高的之一，但该地区对 IPV 的研究仍然不足，尤其是在感染艾滋病毒的妇女（WLWH）中。本研究旨在了解性别和暴力规范如何影响 WLWH 对暴力作为健康问题的解释和优先排序。我们还探讨了 HIV 披露是否被视为 IPV 的触发因素。我们在越南北部对 20 名 WLWH（中位数年龄=35.5 岁；范围=28-54 岁）进行了深入访谈。参与者是从一家门诊抗逆转录病毒治疗（ART）诊所招募的。对半结构化访谈进行了转录、翻译和分析，以使用性别为重点的理论框架确定主题。12 名参与者报告说曾遭受过现任或前任丈夫的 IPV，其中大多数发生在 HIV 诊断之前。只有一名参与者认为她的 HIV 状况是她所经历的 IPV 的一个因素；其余参与者没有明确将 IPV 和 HIV 联系起来。没有一个人在向丈夫透露后表达对 IPV 的恐惧或经历。当被问及女性在社会中的角色时，大多数人谈到了通过做家务、抚养孩子、稳定收入和对丈夫忠诚来建立家庭和谐的责任。参与者认为婚姻冲突是女性的问题，应该避免表现温顺，或者通过默默忍受暴力来和平解决。几乎所有人都报告说从丈夫那里感染了艾滋病毒。无论他们的孩子是否感染（=8）或没有感染（=10），参与者都谈到了被迫启动和坚持接受 ART，以在情感和经济上照顾他们的孩子。在越南的性别规范背景下，参与者在经历 IPV 后寻求帮助的紧迫性较低，在被诊断出 HIV 后寻求帮助的紧迫性较高。需要采取多层次的干预措施来改变对 IPV 可接受性的社会规范。
