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Geller RJ, Decker MR, Adedimeji AA, Weber KM, Kassaye S, Taylor TN, Cohen J, Adimora AA, Haddad LB, Fischl M, Cunningham S, Golub ET. A Prospective Study of Exposure to Gender-Based Violence and Risk of Sexually Transmitted Infection Acquisition in the Women's Interagency HIV Study, 1995-2018. J Womens Health (Larchmt) 2020; 29:1256-1267. [PMID: 32996812 DOI: 10.1089/jwh.2019.7972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Our objectives were to estimate the association of gender-based violence (GBV) experience with the risk of sexually transmitted infection (STI) acquisition in HIV-seropositive and HIV-seronegative women, to compare the STI risks associated with recent and lifetime GBV exposures, and to quantify whether these associations differ by HIV status. Methods: We conducted a multicenter, prospective cohort study in the Women's Interagency HIV Study, 1994-2018. Poisson models were fitted using generalized estimating equations to estimate the association of past 6-month GBV experience (physical, sexual, or intimate partner psychological violence) with subsequent self-reported STI diagnosis (gonorrhea, syphilis, chlamydia, pelvic inflammatory disease, or trichomoniasis). Results: Data from 2868 women who reported recent sexual activity comprised 12,069 person-years. Higher STI risk was observed among HIV-seropositive women (incidence rate [IR] 5.5 per 100 person-years) compared with HIV-seronegative women (IR 4.3 per 100 person-years). Recent GBV experience was associated with a 1.28-fold (95% confidence interval [CI] 0.99, 1.65) risk after adjustment for HIV status and relevant demographic, socioeconomic, and sexual risk variables. Other important risk factors for STI acquisition included unstable housing (adjusted incidence rate ratio [AIRR] 1.81, 95% CI 1.32-2.46), unemployment (AIRR 1.42, 95% CI 1.14-1.76), transactional sex (AIRR 2.06, 95% CI 1.52-2.80), and drug use (AIRR 1.44, 95% CI 1.19-1.75). Recent physical violence contributed the highest risk of STI acquisition among HIV-seronegative women (AIRR 2.27, 95% CI 1.18-4.35), whereas lifetime GBV experience contributed the highest risk among HIV-seropositive women (AIRR 1.59, 95% CI 1.20-2.10). Conclusions: GBV prevention remains an important public health goal with direct relevance to women's sexual health.
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Affiliation(s)
- Ruth J Geller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michele R Decker
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adebola A Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kathleen M Weber
- Cook County Health and Hospitals System/Hektoen Institute of Medicine, Chicago, Illinois, USA
| | - Seble Kassaye
- Department of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Tonya N Taylor
- College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jennifer Cohen
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, USA
| | - Adaora A Adimora
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa B Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Margaret Fischl
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sarah Cunningham
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Elizabeth T Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Hogben M, Leichliter J, Aral SO. An Overview of Social and Behavioral Determinants of STI. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Saxena A, Deschamps MM, Dorvil N, Christophe I, Rosenberg R, Jean-Gilles M, Koenig S, Pape JW, Dévieux JG. Association between intimate partner violence and HIV status among Haitian Women. Glob Public Health 2019; 14:1557-1568. [PMID: 30999807 DOI: 10.1080/17441692.2019.1602156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The prevalence of intimate partner violence (IPV) among women living in Haiti increased from 25% in 2006-29% in 2012, with escalating reports of crisis in the last several years. We examined the association between IPV and HIV status among these women in Haiti. Participants were drawn from a larger sample of women (n = 513) with a history of IPV. Women living with HIV (n = 55) were matched to uninfected women (n = 110) to form a control group. Attitudes towards gender roles, mental and physical well-being, and partner violence were assessed and compared. Logistic regressions were utilised to calculate multivariable-adjusted odds ratios. Women living with HIV were more likely to report more severe forms of psychological violence (p < 0.01), and severe physical violence (p < 0.0001). Women who experienced severe forms of IPV were 3.5 times more likely to have an HIV positive status compared to those who did not experience severe IPV (p < 0.0001). There were significant associations between severe forms of IPV, and HIV status among Haitian women. IPV severity should be integrated into eligibility screening for biomedical strategies of prevention such as pre-exposure prophylaxis (PrEP) among Haitian women.
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Affiliation(s)
- Anshul Saxena
- Florida International University, AIDS Prevention Program , Miami , FL , USA.,Baptist Health South Florida , Miami , FL , USA
| | | | | | | | - Rhonda Rosenberg
- Florida International University, AIDS Prevention Program , Miami , FL , USA
| | - Michèle Jean-Gilles
- Florida International University, AIDS Prevention Program , Miami , FL , USA
| | - Serena Koenig
- Division of Global Health Equity, Brigham and Women's Hospital , Boston , MA , USA
| | - Jean W Pape
- GHESKIO , Port-au-Prince , Haiti.,Department of Medicine, Cornell University, Center for Global Health , New York , NY , USA
| | - Jessy G Dévieux
- Florida International University, AIDS Prevention Program , Miami , FL , USA
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Burgueño E, Carlos S, Lopez-Del Burgo C, Osorio A, Stozek M, Ndarabu A, Muamba P, Tshisuaka P, De Irala J. Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC). PLoS One 2017; 12:e0189632. [PMID: 29253857 PMCID: PMC5734756 DOI: 10.1371/journal.pone.0189632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/29/2017] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Sexual 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. METHODOLOGY Case-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. RESULTS Thirty-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. CONCLUSION Among 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.
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Affiliation(s)
- Eduardo Burgueño
- CEFA-Monkole, Kinshasa, Democratic Republic of the Congo
- School of Medicine, University of Mwene-Ditu, Mwene-Ditu, Democratic Republic of the Congo
| | - Silvia Carlos
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
- * E-mail:
| | - Cristina Lopez-Del Burgo
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Alfonso Osorio
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Maria Stozek
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Adolphe Ndarabu
- Monkole Hospital, Kinshasa, Democratic Republic of the Congo
| | - Philémon Muamba
- School of Law and Politics, Catholic University of Congo, Kinshasa, Democratic Republic of the Congo
| | | | - Jokin De Irala
- Preventive Medicine and Public Health Department, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
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