Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis
Identifieur interne : 001F69 ( Ncbi/Merge ); précédent : 001F68; suivant : 001F70Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis
Auteurs : Chyun-Fung Shi [Canada] ; Fiona G. Kouyoumdjian [Canada] ; Jonathan Dushoff [Canada]Source :
- BMC Public Health [ 1471-2458 ] ; 2013.
Abstract
The relationship between intimate partner violence (IPV) and women’s risk of HIV infection has attracted much recent attention, with varying results in terms of whether there is an association and what the magnitude of association is. Understanding this relationship is important for HIV surveillance and intervention programs.
We analyzed data from the 2008-2009 Demographic and Health Survey (DHS) in Kenya, on 1,904 women aged 15-49. A generalized linear mixed model was adapted to explore the relationship between IPV and HIV prevalence, controlling for sociodemographic variables, and treating DHS survey clusters, province and ethnicity as random effects. We used principal components analysis (PCA) to calculate a single IPV score for each woman. The effect of HIV risk behaviours on the association between IPV and HIV was also assessed.
Controlling for relevant sociodemographic factors, we found that HIV risk was significantly associated with IPV (P <0.01). After adjustment for risk factors as well as sociodemographic variables, the positive association between IPV and HIV remained significant (P=0.035). The estimated effect size of this model corresponds to an odds ratio of 1.55 for HIV infection comparing a woman who experienced no IPV and a woman at the 95th percentile for our IPV index.
This study provides further evidence that IPV and HIV are associated. In addition, we found that this association remains even when we controlled for several HIV risk factors. This implies that IPV can be used as a marker of potential HIV risk, and may be causally associated with HIV risk. Further, these results suggest that IPV monitoring and prevention may have a useful role in HIV prevention in Kenya. Further research, ideally based on longitudinal observations, is needed to disentangle these relationships.
Url:
DOI: 10.1186/1471-2458-13-512
PubMed: 23711189
PubMed Central: 3702473
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis</title><author><name sortKey="Shi, Chyun Fung" sort="Shi, Chyun Fung" uniqKey="Shi C" first="Chyun-Fung" last="Shi">Chyun-Fung Shi</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Biology, McMaster University, Hamilton, ON L8S 4K1</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Kouyoumdjian, Fiona G" sort="Kouyoumdjian, Fiona G" uniqKey="Kouyoumdjian F" first="Fiona G" last="Kouyoumdjian">Fiona G. Kouyoumdjian</name><affiliation wicri:level="4"><nlm:aff id="I2">Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 2J7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 2J7</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dushoff, Jonathan" sort="Dushoff, Jonathan" uniqKey="Dushoff J" first="Jonathan" last="Dushoff">Jonathan Dushoff</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Biology, McMaster University, Hamilton, ON L8S 4K1</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23711189</idno><idno type="pmc">3702473</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702473</idno><idno type="RBID">PMC:3702473</idno><idno type="doi">10.1186/1471-2458-13-512</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001335</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001335</idno><idno type="wicri:Area/Pmc/Curation">001334</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001334</idno><idno type="wicri:Area/Pmc/Checkpoint">001868</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001868</idno><idno type="wicri:Area/Ncbi/Merge">001F69</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis</title><author><name sortKey="Shi, Chyun Fung" sort="Shi, Chyun Fung" uniqKey="Shi C" first="Chyun-Fung" last="Shi">Chyun-Fung Shi</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Biology, McMaster University, Hamilton, ON L8S 4K1</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Kouyoumdjian, Fiona G" sort="Kouyoumdjian, Fiona G" uniqKey="Kouyoumdjian F" first="Fiona G" last="Kouyoumdjian">Fiona G. Kouyoumdjian</name><affiliation wicri:level="4"><nlm:aff id="I2">Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 2J7, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 2J7</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dushoff, Jonathan" sort="Dushoff, Jonathan" uniqKey="Dushoff J" first="Jonathan" last="Dushoff">Jonathan Dushoff</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Biology, McMaster University, Hamilton, ON L8S 4K1</wicri:regionArea><orgName type="university">Université McMaster</orgName><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The relationship between intimate partner violence (IPV) and women’s risk of HIV infection has attracted much recent attention, with varying results in terms of whether there is an association and what the magnitude of association is. Understanding this relationship is important for HIV surveillance and intervention programs.</p></sec><sec><title>Methods</title><p>We analyzed data from the 2008-2009 Demographic and Health Survey (DHS) in Kenya, on 1,904 women aged 15-49. A generalized linear mixed model was adapted to explore the relationship between IPV and HIV prevalence, controlling for sociodemographic variables, and treating DHS survey clusters, province and ethnicity as random effects. We used principal components analysis (PCA) to calculate a single IPV score for each woman. The effect of HIV risk behaviours on the association between IPV and HIV was also assessed.</p></sec><sec><title>Results</title><p>Controlling for relevant sociodemographic factors, we found that HIV risk was significantly associated with IPV (P <0.01). After adjustment for risk factors as well as sociodemographic variables, the positive association between IPV and HIV remained significant (P=0.035). The estimated effect size of this model corresponds to an odds ratio of 1.55 for HIV infection comparing a woman who experienced no IPV and a woman at the 95th percentile for our IPV index.</p></sec><sec><title>Conclusion</title><p>This study provides further evidence that IPV and HIV are associated. In addition, we found that this association remains even when we controlled for several HIV risk factors. This implies that IPV can be used as a marker of potential HIV risk, and may be causally associated with HIV risk. Further, these results suggest that IPV monitoring and prevention may have a useful role in HIV prevention in Kenya. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Public Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Public Health</journal-id><journal-title-group><journal-title>BMC Public Health</journal-title></journal-title-group><issn pub-type="epub">1471-2458</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23711189</article-id><article-id pub-id-type="pmc">3702473</article-id><article-id pub-id-type="publisher-id">1471-2458-13-512</article-id><article-id pub-id-type="doi">10.1186/1471-2458-13-512</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Intimate partner violence is associated with HIV infection in women in Kenya: A cross-sectional analysis</article-title></title-group><contrib-group><contrib contrib-type="author" id="A1"><name><surname>Shi</surname><given-names>Chyun-Fung</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>chyun.shi@gmail.com</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Kouyoumdjian</surname><given-names>Fiona G</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>fiona.kouyoumdjian@mail.utoronto.ca</email></contrib><contrib contrib-type="author" corresp="yes" id="A3"><name><surname>Dushoff</surname><given-names>Jonathan</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>dushoff@mcmaster.ca</email></contrib></contrib-group><aff id="I1"><label>1</label>Department of Biology, McMaster University, Hamilton, ON L8S 4K1, Canada</aff><aff id="I2"><label>2</label>Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 2J7, Canada</aff><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>28</day><month>5</month><year>2013</year></pub-date><volume>13</volume><fpage>512</fpage><lpage>512</lpage><history><date date-type="received"><day>8</day><month>4</month><year>2013</year></date><date date-type="accepted"><day>10</day><month>5</month><year>2013</year></date></history><permissions><copyright-statement>Copyright © 2013 Shi et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Shi et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.biomedcentral.com/1471-2458/13/512"></self-uri><abstract><sec><title>Background</title><p>The relationship between intimate partner violence (IPV) and women’s risk of HIV infection has attracted much recent attention, with varying results in terms of whether there is an association and what the magnitude of association is. Understanding this relationship is important for HIV surveillance and intervention programs.</p></sec><sec><title>Methods</title><p>We analyzed data from the 2008-2009 Demographic and Health Survey (DHS) in Kenya, on 1,904 women aged 15-49. A generalized linear mixed model was adapted to explore the relationship between IPV and HIV prevalence, controlling for sociodemographic variables, and treating DHS survey clusters, province and ethnicity as random effects. We used principal components analysis (PCA) to calculate a single IPV score for each woman. The effect of HIV risk behaviours on the association between IPV and HIV was also assessed.</p></sec><sec><title>Results</title><p>Controlling for relevant sociodemographic factors, we found that HIV risk was significantly associated with IPV (P <0.01). After adjustment for risk factors as well as sociodemographic variables, the positive association between IPV and HIV remained significant (P=0.035). The estimated effect size of this model corresponds to an odds ratio of 1.55 for HIV infection comparing a woman who experienced no IPV and a woman at the 95th percentile for our IPV index.</p></sec><sec><title>Conclusion</title><p>This study provides further evidence that IPV and HIV are associated. In addition, we found that this association remains even when we controlled for several HIV risk factors. This implies that IPV can be used as a marker of potential HIV risk, and may be causally associated with HIV risk. Further, these results suggest that IPV monitoring and prevention may have a useful role in HIV prevention in Kenya. Further research, ideally based on longitudinal observations, is needed to disentangle these relationships.</p></sec></abstract><kwd-group><kwd>Intimate partner violence</kwd><kwd>Generalized linear mixed models</kwd><kwd>DHS</kwd><kwd>HIV</kwd><kwd>Kenya</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Hamilton (Ontario)</li><li>Toronto</li></settlement><orgName><li>Université McMaster</li><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Shi, Chyun Fung" sort="Shi, Chyun Fung" uniqKey="Shi C" first="Chyun-Fung" last="Shi">Chyun-Fung Shi</name></region><name sortKey="Dushoff, Jonathan" sort="Dushoff, Jonathan" uniqKey="Dushoff J" first="Jonathan" last="Dushoff">Jonathan Dushoff</name><name sortKey="Kouyoumdjian, Fiona G" sort="Kouyoumdjian, Fiona G" uniqKey="Kouyoumdjian F" first="Fiona G" last="Kouyoumdjian">Fiona G. 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