Kouyoumdjian, F.G., Calzavara, L.M., Bondy, S.J., et al. AIDS (May 2013), Vol. 27 No. 8, pp. 1311-1338.
The authors used longitudinal data of 10,252 women to compare the risk of incident HIV infection among women who had and had not experienced intimate partner violence (IPV), as well as potential mediators of HIV and IPV interaction in Rakai, Uganda. IPV and incident HIV infection were significantly associated; women who had ever experienced any form of IPV had an adjusted incidence rate ratio (IRR) of 1.55 compared to women who had not experienced IPV. The adjusted population proportion of HIV attributable to IPV was approximately 22 percent. No evidence was found that condom use or number of partners changed the degree of association between IPV and HIV. Verbal abuse was most common, followed by physical and then sexual IPV, but many women experienced these concurrently. Further, long-term, frequent IPV led to a higher HIV risk than less frequent IPV (from an IRR of .84 for having experienced IPV once to 3.03 for having experienced IPV more than 20 times in the past year). The authors said that the findings are likely generalizable throughout Uganda. They concluded that HIV prevention programs should discuss IPV during HIV testing and counseling, and programs to prevent violence towards children and IPV in adulthood are critically needed, not only to address the physical and emotional consequences, but also to prevent HIV.