IJE Advance Access originally published online on September 28, 2006
International Journal of Epidemiology 2006 35(6):1461-1468; doi:10.1093/ije/dyl218
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Factors associated with HIV sero-status in young rural South African women: connections between intimate partner violence and HIV
1 Gender and Health Research Unit, Medical Research Council, Private Bag X385, Pretoria 0001, South Africa.
2 Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA.
3 Biostatistics Unit, Medical Research Council, Private Bag X385, Pretoria 0001, South Africa.
4 College of Public Health, University of Arizona, Tucson, AZ, USA.
5 National Institute for Communicable Disease, Private Bag X4, Sandringham 2131, South Africa.
6 International Council for Research on Women, Washington DC, USA.
* Corresponding author. E-mail: rjewkes{at}mrc.ac.za
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Abstract |
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Background This paper aims to describe factors associated with HIV sero-status in young, rural South African women and the relationship between intimate partner violence (IPV) and HIV.
Methods A total of 1295 sexually active female volunteers, aged 15–26, from 70 villages were recruited to participate in a cluster randomized controlled trial of an HIV behavioural intervention. The main measures were HIV sero-status, and IPV and sexual practices measured using a questionnaire administered during baseline interviews.
Results About 12.4% of women had HIV and 26.6% had experienced more than one episode of physical or sexual IPV. After adjusting for age, HIV infection was associated with having three or more past year partners [odds ratio (OR) 2.39; 95% confidence interval (95% CI) 1.48–3.85], sex in past 3 months (OR 3.33; 95% CI 1.87–5.94), a partner three or more years older (OR 1.69; 95% CI 1.16–2.48), and a more educated partner (OR 1.91; 95% CI 1.30–2.78). IPV was associated with HIV in two-way analyses (OR 1.56; 95% CI 1.08–2.23), but the effect was non-significant after adjusting for HIV risk behaviours. The experience of IPV was strongly associated with past year partner numbers, time of last sex, and partner's education; it was also marginally associated with partner age difference. Adverse experiences in childhood, including sexual abuse, increased the likelihood of having more past year partners (OR 1.43; 95% CI 1.21–1.69).
Conclusions IPV was strongly associated with most of the identified HIV risk factors. Our findings provide further evidence of links between IPV and HIV among women and the importance of joint prevention.
Keywords Intimate partner violence, HIV, risk factors, women
Accepted 31 August 2006
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