7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013)

Abstract

WEPE580 - Poster Exhibition


Prevalence and HIV risk-related correlates of emotional, physical and sexual violence among women at risk for HIV in the United States: data from HPTN 064 (The Women's HIV SeroIncidence Study)

B.E.E. Montgomery1, A. Rompalo2, J. Hughes3, J. Wang4, D. Haley5, L.E. Soto-Torres6, W. Chege6, J.E. Justman7, S.L. Hodder8, on behalf of the HIV Prevention Trials Network (HPTN) 064 Study Team

1University of Arkansas for Medical Sciences, Health Behavior and Health Education, Little Rock, United States, 2Johns Hopkins School of Medicine, Medicine, Baltimore, United States, 3University of Washington, Biostatistics, Seattle, United States, 4Statistical Center for HIV/AIDS Research & Prevention (SCHARP), Fred Hutchinson Cancer Research Center, Seattle, United States, 5FHI 360, Durham, United States, 6National Institute of Allergy and Infectious Diseases, Bethesda, United States, 7Columbia University, Mailman School of Public Health, New York, United States, 8University of Medicine and Dentistry of New Jersey, Medicine, Newark, United States

Background: Though violence against women (VAW) is associated with increased HIV risk, few large studies have examined prevalence and correlates of VAW among women living in US communities with high levels of poverty and HIV. HPTN 064 data were used to assess prevalence of and factors associated with emotional, physical, and sexual violence experienced by enrolled women.
Methods: Women ages 18-44 years were recruited using ethnographic mapping and venue-based sampling in 10 US communities with high HIV prevalence and poverty. Eligibility included no prior self-reported HIV diagnosis and >1 individual or sexual partner risk characteristic. Participants were followed 6-12 months with audio-computer-assisted self-interviews (ACASI) assessing violence. Multivariate logistic regression using p< 0.1 predictors from univariate models examined baseline characteristics associated with and without experiencing violence.
Results: 2,099 women (86 % Black, median age 29 years, and 65% unemployed) were enrolled. Overall prevalence of emotional abuse, physical and sexual violence, and experiencing multiple types of violence in past 6-months were 32% (n=656), 19% (n=401), 7% (n=148), and 17% (n=356), respectively. Types of violence were highly associated with each other (all pairwise OR p< 0.0001). Emotional violence was significantly associated with several risk behaviors. Other violence variables were associated with fewer risk behaviors (table).
Conclusion: VAW was prevalent, especially among younger women and survivors of childhood victimization. Women experiencing violence, particularly emotional abuse, were more likely to engage in some HIV risk behaviors, suggesting that this population requires comprehensive HIV prevention interventions that include attention to mental health and substance abuse issues.

CharacteristicEmotional Abuse, AOR (95% CI)Physical Violence, AOR (95% CI)Sexual Violence, AOR (95% CI)Multiple Types of Violence, AOR (95% CI)
Age (34+ vs 18-26)0.35 (0.23, 0.53)0.45 (0.28, 0.71)0.96 (0.49, 1.88)0.41 (0.25, 0.68)
(27-33 vs 18-26)0.54 (0.37, 0.79)0.53 (0.35, 0.79)0.77 (0.40, 1.49)0.49 (0.32, 0.76)
Childhood abuse2.56 (1.90, 3.44)2.00 (1.44, 2.76)1.92 (1.16, 3.15)2.26 (1.60, 3.20)
Depression symptoms2.75 (2.04, 3.72)2.33 (1.66, 3.25)1.87 (1.13, 3.12)2.57 (1.81, 3.66)
Cocaine Use1.91 (1.15, 3.18)1.99 (1.16, 3.44)1.09 (0.52, 2.28)2.47 (1.42, 4.29)
Multiple partners0.58 (0.39, 0.86)0.95 (0.61, 1.49)0.82 (0.39, 1.75)0.89 (0.55, 1.46)
Exchange sex1.66 (1.16, 2.37)1.32 (0.90, 1.95)1.4 (0.79, 2.58)1.38 (0.91, 2.09)
Unknown partner HIV status1.38 (1.03, 1.86)1.05 (0.76, 1.44)1.17 (0.70, 1.95)1.02 (0.72, 1.44)
IDU partner1.58 (1.13, 2.20)1.34 (0.93, 1.93)2.13 (1.22, 3.73)1.48 (1.01, 2.18)
[Table: Correlates of VAW (bold denotes p<0.05)]


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