Sunday, June 21, 2015

Intimate partner violence and the association with HIV

Over the past decade strong evidence has emerged on the relationship between intimate partner violence and HIV. There is equally strong evidence for and recognition of successful community strategies to prevent intimate partner violence and vulnerability to HIV (16, 29, 30, 57).
In high HIV prevalence settings, women who are exposed to intimate partner violence are 50% more likely to acquire HIV than those who are not exposed (16).
Adolescent girls and young women also have the highest incidence of intimate partner violence (11). In Zimbabwe, for example, the prevalence of intimate partner violence among women aged 15–24 years is 35%, compared with 24% for women aged 25–49 years; and in Gabon, prevalence of intimate partner violence among young women is 42% compared with 28% for older women. In some settings, 45% of adolescent girls report that their first experience of sex was forced, another
known risk factor for HIV (Fig. 4) (17). In addition, girls who marry before age 18 are more likely to experience violence within marriage than girls who marry later (14).
According to the United Nations Children’s Fund (UNICEF), globally 120 million girls – 1 in 10 – are raped or sexually attacked by the age of 20 years (15).

11. The gap report. Geneva: Joint United Nations Programme on HIV/AIDS; 2014
14. Marrying too young: end child marriage. New York: United Nations Population Fund;2012.
15. UNICEF. Hidden in plain sight. A statistical analysis of violence against children. 2014.
16. Jewkes RK, Dunkle K, Nduna M, Shai M. Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study. Lancet. 2010;376:41–48.
17. WHO multi-country study on women’s health and domestic violence against women: initial results on prevalence, health outcomes and women’s responses. Geneva: World Health Organization; 2005
29. Raising Voices. SASA!
30. Wagman JA, Gray RH, Campbell JC, Thoma M, Ndyanabo A, Ssekasanvu J, et al. Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort. Lancet Glob Health. 2015;3:e23–e33.
57. Leclerc-Madlala S., Age disparate and intergeneration sex in southern Africa, the dynamics of hyper vulnerability. AIDS 2008, 22 suppl 4: S17-S25

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