A prospective study of frequency and correlates of intimate partner violence among African heterosexual HIV serodiscordant couples

Abstract

Background—Intimate partner violence (IPV) is common worldwide and is an important consideration in couples HIV voluntary counseling and testing (CVCT), especially for HIV serodiscordant couples (i.e., in which only one member is HIV infected). Design—Prospective study of 3408 HIV serodiscordant couples (2299 in which the HIV infected partner was female) from 7 countries from East and Southern Africa. Methods—At quarterly visits during up to 2 years of follow-up, participants were asked, separately, about IPV perpetrated against them by their partner during the prior 3 months. Correlates of IPV were determined by generalized estimating equations. Results—The majority of couples were married and living together, with an average duration of partnership of approximately 5 years. More than 39,000 quarterly visits were recorded. IPV was reported in 2.7% of visits by HIV infected women, 2.2% by HIV uninfected women, 0.9% by HIV infected men, and 0.7% by HIV uninfected men. The majority of IPV reports were verbal or a combination of verbal and physical violence. Those who were HIV infected were more likely to report IPV (for women adjusted odds ratio [AOR] 1.33, p=0.043; for men AOR 2.20, p=0.001), but IPV was not significantly associated with risk of HIV seroconversion in HIV uninfected participants. IPV incidence decreased during follow-up (p<0.001). Conclusions—During up to 2 years of prospective follow-up, most persons in stable HIV serodiscordant partnerships who had undergone CVCT did not report IPV. A modest increased risk of IPV was seen for HIV infected partners, both female and male