Prevalence and Risk Factors for Intimate Partner Violence in Women Living with HIV in Uganda

BACKGROUND: Intimate partner violence (IPV), behavior within an intimate relationship that causes physical, sexual, or psychological harm, is a significant global health problem. IPV is associated with HIV incidence, reduced antiretroviral (ART) adherence, and a lower likelihood of viral load suppression. To inform future IPV interventions we examined IPV prevalence and IPV risk factors among women living with HIV (WLWH) in Uganda. METHODS: We utilized prospective data from women enrolled in the Uganda AIDS Rural Treatment Outcomes (UARTO) cohort study of HIV-infected adults receiving ART between 2011 and 2015. Bloodwork (CD4 cells/mm3, HIV-RNA) and interviewer-administered questionnaires (socio-demographics, behavior, and health outcomes) were completed quarterly. Sexual and reproductive health data, including IPV and relationship dynamics, were collected annually. We performed analyses with the primary outcome of experiencing physical or sexual IPV at any time during the follow-up period (yes vs. no). Multivariate logistic regression was used to assess socioeconomic and clinical factors associated with IPV. RESULTS: A total of 455 WLWH were included. Median age was 36.3 years, 43% were married, and median time on ART was 4 years. At baseline,131 women (29%) reported a history of experiencing IPV. Over study follow-up, 68 women (15%) reported experiencing current physical or sexual IPV at least once. Of those 68 women, 22 (32%) experienced physical violence only, 30 (44%) experienced sexual violence only, and 16 (24%) experienced both. In the adjusted model, younger age per year (AOR 1.06, 95% CI 1.04–1.10), hazardous drinking (AOR 3.31, 95% CI 1.14–9.63), and being married (AOR 2.64, 95% CI 1.47–4.72) were associated with higher odds of experiencing current IPV. CONCLUSION: Experiences of physical and sexual IPV are common among women in this study, and many experienced both sexual and physical violence. These results highlight the need to develop effective and integrated IPV screening and treatment interventions for women accessing HIV care. Further research is needed to better understand how alcohol use, younger age, and marital status play a role in the risk of IPV, to inform development and testing of IPV interventions for WLWH. DISCLOSURES: J. E. Haberer, Merck: Consultant, Consulting fee; Natera: Shareholder, Stock ownership