A prospective study of frequency and correlates of intimate partner violence among African heterosexual HIV serodiscordant couples

Abstract

Background: Intimate partner violence (IPV) is common worldwide and is an important consideration in couples HIV voluntary counseling and testing (CVCT), especially for HIV-serodiscordant couples (i.e. in which only one member is HIV-infected).

Design: Prospective study of 3408 HIV-serodiscordant couples (2299 in which the HIV-infected partner was female) from seven countries from East and Southern Africa.

Methods: At quarterly visits during up to 2 years of follow-up, participants were asked, separately, about IPV perpetrated against them by their partner during the prior 3 months. Correlates of IPV were determined by generalized estimating equations.

Results: The majority of couples were married and living together, with an average duration of partnership of approximately 5 years. More than 39,000 quarterly visits were recorded. IPV was reported in 2.7% of visits by HIV-infected women, 2.2% by HIV-uninfected women, 0.9% by HIV-infected men, and 0.7% by HIV-uninfected men. The majority of IPV reports were verbal or a combination of verbal and physical violence. Those who were HIV-infected were more likely to report IPV [for women adjusted odds ratio (AOR) 1.33, P = 0.043; for men AOR 2.20, P = 0.001], but IPV was not significantly associated with risk of HIV seroconversion in HIV-uninfected participants. IPV incidence decreased during follow-up (P < 0.001).

Conclusion: During up to 2 years of prospective follow-up, most persons in stable HIV-serodiscordant partnerships who had undergone CVCT did not report IPV. A modest increased risk of IPV was seen for HIV-infected partners, both female and male.

Figure 1. Cumulative probability of reporting IPV, by gender and HIV status

Cumulative proportion of persons reporting IPV during study follow-up, by HIV status and gender, as calculated by Kaplan-Meier analysis. At 24 months, the cumulative probability of any IPV report was 18.0% for HIV infected women, 14.4% for HIV uninfected women, 7.1% for HIV infected men, and 5.0% for HIV uninfected men.