Prior Exposure to Intimate Partner Violence Associated With Less HIV Testing Among Young Women

Abstract

Low-income minority women are disproportionately represented among those living with HIV in the United States. They are also at risk for the SAVA (substance abuse, violence, and HIV/AIDS) syndemic issues. Women who have recently given birth are at high risk for substance use and intimate partner violence (IPV), and HIV testing is not routinely administered during the postpartum visit. We explored the relationship between substance use, IPV, and HIV testing among low-income young adult women attending Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federally supported nutrition program. A survey assessed substance use, relationships in particular with violence exposure, and HIV testing behavior in the past 6 months among a convenience sample of 100 women aged 18 to 30. The survey was conducted at several WIC offices in an urban setting in the Mid-Atlantic region between June and December 2015. Physical violence was the only IPV variable significantly associated ( p = .022) with not being tested for HIV in the past 6 months, remaining significant even after adjusting for demographic and other significant variables (adjusted odds ratio [AOR] = 0.02; 95% confidence interval [CI] = [0.00, 0.41]). Women exposed to physical IPV or psychological IPV in the past year were significantly more likely to have ever used an illicit drug (physical IPV: 34% vs. 59%, p = .052; psychological IPV: 22% vs. 53%. p = .002). These findings between physical IPV and HIV testing history highlight the need to further understand how the context of violence affects HIV testing behaviors. Providing convenient, safe, and accessible HIV testing sites in spaces like WIC may increase HIV testing rates overall and specifically among women experiencing IPV.

Violence Exposure, Drug Use and HIV/AIDS Risk Taking Behaviors: The Role of Gender

“…7,8,11,14 It also supports prior findings that ETV affects sexual behaviors and risk for HIV. 4,15,21 The current study clarifies the relative importance of different ETV factors. Prior studies have often been uneven in their use of ETV factors.…”

“…The results from this study support prior findings that violence exposure over the life course is related to substance abuse into adulthood. 5,[10][11][12][13][14][15] Particularly as it relates to the differences in effects across gender. 7,8,11,14 It also supports prior findings that ETV affects sexual behaviors and risk for HIV.…”

“…4,5,7,8,11,31 ETV factors have typically been divided into categories based on geography and location of violent event 31 , specified consistency of violence exposure in the neighborhood or from parents 8,11 , focused on neighborhood exposures to violence 12 , focus on the Adverse Childhood Experience index or a similar index which combines multiple types of trauma in some analyses 13,21 , or focused on intimate partner violence. 15 Additionally, Hedtke and colleagues 10 and Wilson and Donenberg 22 separated witnessing violence and experiencing sexual and physical assault in their models, but focused on women and used these variables as predictors of mental health, substance use, or sexual risk outcomes. By showing how different dimensions of witnessing and experiencing violence affect a range of substance use and HIV outcomes, this study specifies the strongest factors predicting those outcomes across genders.…”

“…Experiencing physical violence has also been associated with not being HIV tested in the last 6 months. 15 In another study linking CVE to HIV sexual risk behaviors among African American adolescents, Voisin 20,21 found that the relationship between sexual risk behaviors and CVE were linked to negative perceptions of peer attitudes about safer sex.…”

“…Adolescent violence exposure is related to substance abuse, including into adulthood. 5,8,[10][11][12][13][14][15] The relationship between ETV and substance use has been found to be generally cumulative with each incidence of violence exposure increasing the likelihood of subsequent substance abuse. 10,13 Adolescents who have been exposed to violence are more likely to report using tobacco and marijuana than their peers with no exposure.…”