Intersection of Intimate Partner Violence and HIV in Women

Intimate partner violence (IPV) includes physical violence, sexual violence, threats of physical or sexual violence, stalking and psychological aggression (including coercive tactics) by a current or former intimate partner.

Findings from a National Intimate Partner and Sexual Violence Survey (NISVS) indicate that 35.6% of women in the United States have experienced rape, physical violence, or stalking by an intimate partner in their lifetime.

In addition, 1 in 5 women have experienced an attempted, completed, or alcohol-drug facilitated rape (defined as a physically forced or threatened vaginal, oral, and/or anal penetration) in their lifetime, mostly by a current or former partner.

Exposure to IPV can increase women’s risk for human immunodeficiency virus (HIV) infection through:

  • forced sex with an infected partner
  • limited or compromised negotiation of safer sex practices
  • increased sexual risk-taking behaviors

Links between IPV and HIV

The association between violence against women and risk for HIV infection has been the focus of a growing number of studies. Findings from these studies indicate:

  • Women and men who report a history of IPV victimization are more likely than those who do not to report behaviors known to increase the risk for HIV, including injection drug use, treatment for a sexually transmitted infection (STI), giving or receiving money or drugs for sex, and anal sex without a condom. This is true even when other factors such as demographic characteristics, other unhealthy behaviors (smoking, heavy drinking, high body mass index) and negative health conditions (e.g., stroke, disability, and asthma) are similar.
  • HIV-positive women in the United States experience IPV at rates that are higher than for the general population. Across a number of studies, the rate of IPV among HIV-positive women (55%) was double the national rate, and the rates of childhood sexual abuse (39%) and childhood physical abuse (42%) were more than double the national rate.
  • Rates of violence victimization among HIV-positive women are comparable to those for HIV-negative women drawn from similar populations and with similar levels of HIV risk behaviors. However, HIV-positive women may experience abuse that is more frequent and more severe.
  • Women in relationships with violence have four times the risk for contracting STIs, including HIV, than women in relationships without violence.
  • Fear of violence can influence whether some women get tested for HIV. However, in one US study, fear of partner notification and partner violence were not statistically associated with women’s decisions to get or not get an HIV test.
  • Sexual abuse in childhood and forced sexual initiation in adolescence are associated with increased HIV risk-taking behaviors, including sex with multiple partners, sex with unfamiliar partners, sex with older partners, alcohol-related risky sex, anal sex, and low rates of condom use as well as HIV infection, in adult women.

Relationship violence and trauma history can compromise the health and prevention practices of women living with HIV. Recently abused women have more than 4 times the rate of antiretroviral therapy failure, and of not practicing safe sex, as women who have not experienced abuse recently.

 

Source: Centers for Disease Control and Prevention: www.cdc.gov