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Intimate partner violence experienced by HIV-infected pregnant women in South Africa: a cross-sectional study

Identifieur interne : 003955 ( Ncbi/Checkpoint ); précédent : 003954; suivant : 003956

Intimate partner violence experienced by HIV-infected pregnant women in South Africa: a cross-sectional study

Auteurs : Molly Bernstein [Afrique du Sud] ; Tamsin Phillips [Afrique du Sud] ; Allison Zerbe [États-Unis] ; James A. Mcintyre [Afrique du Sud] ; Kirsty Brittain [Afrique du Sud] ; Greg Petro [Afrique du Sud] ; Elaine J. Abrams [États-Unis] ; Landon Myer [Afrique du Sud]

Source :

RBID : PMC:5013465

Abstract

Objectives

Intimate partner violence (IPV) during pregnancy may be common in settings where HIV is prevalent but there are few data on IPV in populations of HIV-infected pregnant women in Southern Africa. We examined the prevalence and correlates of IPV among HIV-infected pregnant women.

Setting

A primary care antenatal clinic in Cape Town, South Africa.

Participants

623 consecutive HIV-infected pregnant women initiating lifelong antiretroviral therapy.

Measures

IPV, depression, substance use and psychological distress were assessed using the 13-item WHO Violence Against Women questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), Alcohol and Drug Use Disorders Identification Tests (AUDIT/DUDIT) and the Kessler 10 (K-10) scale, respectively.

Results

The median age in the sample was 28 years, 97% of women reported being in a relationship, and 70% of women reported not discussing and/or agreeing on pregnancy intentions before conception. 21% of women (n=132) reported experiencing ≥1 act of IPV in the past 12 months, including emotional (15%), physical (15%) and sexual violence (2%). Of those reporting any IPV (n=132), 48% reported experiencing 2 or more types. Emotional and physical violence was most prevalent among women aged 18–24 years, while sexual violence was most commonly reported among women aged 25–29 years. Reported IPV was less likely among married women, and women who experienced IPV were more likely to score above threshold for substance use, depression and psychological distress. In addition, women who reported not discussing and/or not agreeing on pregnancy intentions with their partner prior to conception were significantly more likely to experience violence.

Conclusions

HIV-infected pregnant women in the study reported experiencing multiple forms of IPV. While the impact of IPV on maternal and child health outcomes in the context of HIV infection requires further research attention, IPV screening and support services should be considered within the package of routine care for HIV-infected pregnant women.

Trial registration number

NCT01933477.


Url:
DOI: 10.1136/bmjopen-2016-011999
PubMed: 27531735
PubMed Central: 5013465


Affiliations:


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PMC:5013465

Le document en format XML

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<addr-line>Division of Epidemiology & Biostatistics</addr-line>
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<addr-line>Cape Town</addr-line>
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<country>South Africa</country>
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<addr-line>Division of Epidemiology & Biostatistics</addr-line>
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,
<addr-line>Cape Town</addr-line>
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<country>South Africa</country>
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<addr-line>Department of Obstetrics & Gynaecology</addr-line>
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<institution>University of Cape Town</institution>
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<addr-line>Cape Town</addr-line>
,
<country>South Africa</country>
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<country>USA</country>
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<country xml:lang="fr">États-Unis</country>
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<name sortKey="Myer, Landon" sort="Myer, Landon" uniqKey="Myer L" first="Landon" last="Myer">Landon Myer</name>
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<addr-line>Division of Epidemiology & Biostatistics</addr-line>
,
<institution>School of Public Health & Family Medicine, University of Cape Town</institution>
,
<addr-line>Cape Town</addr-line>
,
<country>South Africa</country>
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<country xml:lang="fr">Afrique du Sud</country>
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<sec>
<title>Objectives</title>
<p>Intimate partner violence (IPV) during pregnancy may be common in settings where HIV is prevalent but there are few data on IPV in populations of HIV-infected pregnant women in Southern Africa. We examined the prevalence and correlates of IPV among HIV-infected pregnant women.</p>
</sec>
<sec>
<title>Setting</title>
<p>A primary care antenatal clinic in Cape Town, South Africa.</p>
</sec>
<sec>
<title>Participants</title>
<p>623 consecutive HIV-infected pregnant women initiating lifelong antiretroviral therapy.</p>
</sec>
<sec>
<title>Measures</title>
<p>IPV, depression, substance use and psychological distress were assessed using the 13-item WHO Violence Against Women questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), Alcohol and Drug Use Disorders Identification Tests (AUDIT/DUDIT) and the Kessler 10 (K-10) scale, respectively.</p>
</sec>
<sec>
<title>Results</title>
<p>The median age in the sample was 28 years, 97% of women reported being in a relationship, and 70% of women reported not discussing and/or agreeing on pregnancy intentions before conception. 21% of women (n=132) reported experiencing ≥1 act of IPV in the past 12 months, including emotional (15%), physical (15%) and sexual violence (2%). Of those reporting any IPV (n=132), 48% reported experiencing 2 or more types. Emotional and physical violence was most prevalent among women aged 18–24 years, while sexual violence was most commonly reported among women aged 25–29 years. Reported IPV was less likely among married women, and women who experienced IPV were more likely to score above threshold for substance use, depression and psychological distress. In addition, women who reported not discussing and/or not agreeing on pregnancy intentions with their partner prior to conception were significantly more likely to experience violence.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>HIV-infected pregnant women in the study reported experiencing multiple forms of IPV. While the impact of IPV on maternal and child health outcomes in the context of HIV infection requires further research attention, IPV screening and support services should be considered within the package of routine care for HIV-infected pregnant women.</p>
</sec>
<sec>
<title>Trial registration number</title>
<p>NCT01933477.</p>
</sec>
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