The HPTN 071(PopART) study was a community-randomised trial in Zambia and
South Africa, examining the impact of combination-prevention including universal
testing and treatment (UTT), on HIV-incidence. This sub-study evaluated factors
associated with IPV (physical and/or sexual) to identify differences by HIV status.
During 2015–16, a random subset of adults who participated in the first year of the
PopART intervention were recruited and standardised questionnaires were
administered. Logistic regression was performed to estimate odds ratios of factors associated with IPV. Among > 700 women studied (300 HIV-negative;400 HIV-positive),
~ 20% reported experiencing physical and/or sexual violence in the last 12-months.
Sexual violence was similar by HIV status, but physical violence and reporting both
physical/sexual violence was more common among HIV-positive women. Spending
nights away from the community in the last 12-months was associated with higher odds
of IPV among both HIV-negative (aOR 3.17, 95% CI 1.02–9.81) and HIV-positive women
(aOR 1.79, 95% CI 0.99–3.24). Among HIV-positive women, financial autonomy was
associated with reduced IPV (aOR:0.41,95%CI:0.23-0.75) while pregnancy in the last
12-months (aOR 2.25, 95% CI 1.07–4.74), risk of alcohol dependence
(aOR 2.75, 95% CI 1.51–5.00) and risk of mental distress (aOR 2.62, 95% CI 1.33–5.16)
were associated with increased IPV. Among HIV-negative women reporting sex in the
last 12-months, transactional sex (aOR 3.97, 95% CI 1.02–15.37) and not knowing
partner’s HIV status (aOR 3.01, 95% CI 1.24–7.29) were associated with IPV. IPV was
commonly reported in the study population and factors associated with IPV differed by
HIV status. The association of mobility with IPV warrants further research. The high
prevalence of harmful alcohol use and mental distress, and their association with IPV
among HIV-positive women require urgent attention.