Brooke E E Montgomery1, Anne Rompalo1, James Hughes1, Jing Wang1, Danielle Haley1, Lydia Soto-Torres1, Wairimu Chege1, Jessica Justman1, Irene Kuo1, Carol Golin1, Paula Frew1, Sharon Mannheimer1, Sally Hodder1. 1. Brooke E. E. Montgomery is with the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. Anne Rompalo is with the Johns Hopkins School of Medicine, Baltimore, MD. James Hughes and Jing Wang are with Fred Hutchinson Cancer Research Center, Seattle, WA. Danielle Haley is with FHI 360, Durham, NC. Lydia Soto-Torres and Wairimu Chege are with the National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, MD. Jessica Justman is with the Mailman School of Public Health, Columbia University, New York, NY. Irene Kuo is with the School of Public Health and Health Services, George Washington University, Washington, DC. Carol Golin is with the Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Paula Frew is with the School of Medicine, Emory University, Atlanta, GA. Sharon Mannheimer is with the College of Physicians and Surgeons, Mailman School of Public Health, Columbia University. At the time of study, Sally Hodder was with the New Jersey Medical School, Rutgers University, Newark.
Abstract
OBJECTIVES: We determined the prevalence of recent emotional, physical, and sexual violence against women and their associations with HIV-related risk factors in women living in the United States. METHODS: We performed an assessment of women ages 18 to 44 years with a history of unprotected sex and 1 or more personal or partner HIV risk factors in the past 6 months from 2009 to 2010. We used multivariable logistic regression to examine the association of experiencing violence. RESULTS: Among 2099 women, the prevalence of emotional abuse, physical violence, and sexual violence in the previous 6 months was 31%, 19%, and 7%, respectively. Nonmarried status, food insecurity, childhood abuse, depression symptomology, and posttraumatic stress disorder were significantly associated with multiple types of violence. All types of violence were associated with at least 3 different partner or personal HIV risk behaviors, including unprotected anal sex, previous sexually transmitted infection diagnosis, sex work, or partner substance abuse. CONCLUSIONS: Our data suggested that personal and partner HIV risk behaviors, mental illness, and specific forms of violence frequently co-occurred in the lives of impoverished women. We shed light on factors purported to contribute to a syndemic in this population. HIV prevention programs in similar populations should address these co-occurring issues in a comprehensive manner.
OBJECTIVES: We determined the prevalence of recent emotional, physical, and sexual violence against women and their associations with HIV-related risk factors in women living in the United States. METHODS: We performed an assessment of women ages 18 to 44 years with a history of unprotected sex and 1 or more personal or partner HIV risk factors in the past 6 months from 2009 to 2010. We used multivariable logistic regression to examine the association of experiencing violence. RESULTS: Among 2099 women, the prevalence of emotional abuse, physical violence, and sexual violence in the previous 6 months was 31%, 19%, and 7%, respectively. Nonmarried status, food insecurity, childhood abuse, depression symptomology, and posttraumatic stress disorder were significantly associated with multiple types of violence. All types of violence were associated with at least 3 different partner or personal HIV risk behaviors, including unprotected anal sex, previous sexually transmitted infection diagnosis, sex work, or partner substance abuse. CONCLUSIONS: Our data suggested that personal and partner HIV risk behaviors, mental illness, and specific forms of violence frequently co-occurred in the lives of impoverished women. We shed light on factors purported to contribute to a syndemic in this population. HIV prevention programs in similar populations should address these co-occurring issues in a comprehensive manner.
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