Violence victimization after HIV infection in a US probability sample of adult patients in primary care

Abstract

OBJECTIVES: This study estimated the proportion of HIV-infected adults who have been assaulted by a partner or someone important to them since their HIV diagnosis and the extent to which they reported HIV-seropositive status as a cause of the violence. METHODS: Study participants were from a nationally representative probability sample of 2864 HIV-infected adults who were receiving medical care and were enrolled in the HIV Costs and Service Utilization Study. All interviews (91% in person, 9% by telephone) were conducted with computer-assisted personal interviewing instruments. Interviews began in January 1996 and ended 15 months later. RESULTS: Overall, 20.5% of the women, 11.5% of the men who reported having sex with men, and 7.5% of the heterosexual men reported physical harm since diagnosis, of whom nearly half reported HIV-seropositive status as a cause of violent episodes. CONCLUSIONS: HIV-related care is an appropriate setting for routine assessment of violence. Programs to cross-train staff in antiviolence agencies and HIV care facilities need to be developed for men and women with HIV infection.

Investigating Partner Abuse Among HIV-Positive Men Who have Sex with Men

“…Further, over half (55%) of the men reported at least one experience with PA victimization in the past year. Our data update previously published findings about PA in HIV-positive outpatients collected in the 1990s [6, 21, 23, 24], before the widespread rollout of ARVs and before living with HIV was more akin to managing a chronic illness.…”

“…Across studies, younger age has been consistently associated with PA experiences in various populations [6, 21, 24, 67, 68], as it was in our sample. This finding has been theorized to be related to the trend in the general population for aggression to recede over time.…”

“…Further, victimization-related injuries are related to physical and mental health outcomes (e.g., poor health status, poor health-related quality of life, high utilization of health services) even after the abuse ends [13–17]. In addition to these general risk factors, PA among individuals living with HIV/AIDS may also be related to disclosure [18, 19], the increased stress or burden of physical problems brought on by managing a chronic illness like HIV, or a potentially higher need for caretaking and support from relationship partners [8, 13, 20, 21]. Also, an HIV-positive PA victim may have fears of abandonment that are intensified through a negative self-image and hopeless view about being able to find a non-abusive partner later [22].…”

Intersectional stigma among midlife and older Black women living with HIV

“…Women described male sexual partners’ behaviours as duplicitous, knowingly infecting them with HIV, deceiving them into taking ART, and abandoning them altogether. Gender-based violence and gender inequality are increasingly noted as important determinants of HIV risk for women; however further research on possible connections is necessary (Zierler et al 2000). The literature on violence among HIV-positive women has noted that violence and victimisation rates among HIV-positive women are comparable to those for HIV-negative women from similar populations and with comparable levels of HIV risk behaviours, with HIV-positive women potentially experiencing more recurrent and severe forms of abuse (Campbell et al 2008; Gielen et al 2007; Zierler et al 2000).…”

“…Gender-based violence and gender inequality are increasingly noted as important determinants of HIV risk for women; however further research on possible connections is necessary (Zierler et al 2000). The literature on violence among HIV-positive women has noted that violence and victimisation rates among HIV-positive women are comparable to those for HIV-negative women from similar populations and with comparable levels of HIV risk behaviours, with HIV-positive women potentially experiencing more recurrent and severe forms of abuse (Campbell et al 2008; Gielen et al 2007; Zierler et al 2000). Our findings show that women reporting IPV described a history of abuse and noted that an HIV-positive status generates additional forms of violence, suggesting that these issues persist into midlife and older age and may be complicated by long-term relationships with a husband or partner.…”