Brooks R D, Jolly P E, Marsh L, Velazquez J M, Padilla L, Jaoko W G
Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
Department of Medical Microbiology, School of Medicine, University of Nairobi, Nairobi, Kenya.
Int J Womens Health. 2019 Aug 19;11:451-461. doi: 10.2147/IJWH.S203327. eCollection 2019.
This study was conducted to identify the prevalence and sociodemographic factors associated with four forms of intimate partner violence (IPV) among HIV-positive women attending the Comprehensive Care Centre at the Kenyatta National Hospital in Nairobi, Kenya.
A cross-sectional study was conducted among 600 sexually active HIV-positive women aged 18-69 years from May to August of 2012. A structured questionnaire including questions pertaining to sociodemographic characteristics, health care decisions, and forms of IPV (controlling behavior, emotional abuse, physical violence, and sexual violence) was administered to each woman.
All women reported experiencing emotional abuse; 20%, 17%, and 15% experienced controlling behavior, physical violence, and sexual violence, respectively. Women who reported low/below average socioeconomic status (SES) had a greater likelihood of experiencing controlling behavior than women with high/average SES (adjusted odds ratio [aOR] =1.62, 95% CI 1.05-2.51). Women who were unemployed had greater odds of experiencing physical violence than those who were employed (aOR =2.35, 95% CI 1.31-4.23). Non-Christian women had higher odds of experiencing controlling behavior, physical violence, and sexual violence than Christian women (aOR =4.41, 95% CI 1.81-10.76 and aOR =3.33, 95% CI 1.43-7.80).
Based on the prevalence of IPV and the sociodemographic factors identified to be associated with IPV among women in this study it may be beneficial to include IPV screening as part of routine clinic visits for HIV-positive and other women. Furthermore, women who report emotional abuse or controlling behavior from spouse should not be overlooked, as these two forms of IPV may precede or accompany physical and sexual IPV. Women who report experiencing IPV during clinic visits may be referred to organizations and resources available to battered women in Kenya. Increased funding for anti-IPV programs and changes in policy may also contribute to a reduction in IPV among HIV-positive and other women in Kenya.
本研究旨在确定肯尼亚内罗毕肯雅塔国家医院综合护理中心感染艾滋病毒的女性中,与四种亲密伴侣暴力形式(IPV)相关的患病率及社会人口学因素。
2012年5月至8月,对600名年龄在18 - 69岁之间有性活动的感染艾滋病毒的女性进行了一项横断面研究。向每位女性发放一份结构化问卷,内容包括社会人口学特征、医疗保健决策以及IPV形式(控制行为、情感虐待、身体暴力和性暴力)相关问题。
所有女性均报告遭受过情感虐待;分别有20%、17%和15%的女性经历过控制行为、身体暴力和性暴力。报告社会经济地位(SES)低/低于平均水平的女性比SES高/平均水平的女性更有可能经历控制行为(调整后的优势比[aOR]=1.62,95%置信区间1.05 - 2.51)。失业女性遭受身体暴力的几率高于就业女性(aOR =2.35,95%置信区间1.31 - 4.23)。非基督教女性比基督教女性更有可能经历控制行为、身体暴力和性暴力(aOR =4.41,95%置信区间1.81 - 10.76;aOR =3.33,95%置信区间1.43 - 7.80)。
基于本研究中IPV的患病率以及确定的与感染艾滋病毒女性中IPV相关的社会人口学因素,将IPV筛查纳入艾滋病毒阳性及其他女性的常规门诊就诊可能是有益的。此外,报告遭受配偶情感虐待或控制行为的女性不应被忽视,因为这两种IPV形式可能先于或伴随身体和性方面的IPV出现。在门诊就诊时报告遭受IPV的女性可被转介至肯尼亚为受虐妇女提供服务的组织和资源处。增加对反IPV项目的资金投入以及政策变革也可能有助于减少肯尼亚感染艾滋病毒及其他女性中的IPV现象。