Keep violent hubbies at bay, or face HIV risk

[Guest guest]

[Editors note: I did not manage to locate the original article- which this news

item is based on. If any of the readers of this FORUM could provide the link to

this article or a copy of this article, it will be appreciated]

Keep violent hubbies at bay, or face HIV risk

Harvard study seeks to establish direct link between intimate partner violence

and high HIV risk

NEW DELHI: Married Indian women facing physical and sexual violence from

husbands are more susceptible to HIV, compared with those who do not suffer such

violence, a study published in the latest issue of Journal of American Medicine

Archives says.

India is home to around 2.5million HIV+, third highest in the world, and women

account for a rising percentage, with husbands’ risk behaviour contributing

heavily to the infection.

“Intimate partner violence (IPV) is associated with heterosexual transmission

of HIV to women in India and elsewhere,†the study claims.

Conducted by Harvard School of Public Health, Boston, the study also had a few

Indian experts on board who conducted a study in 2007-2008 to assess the

relationship between IPV and HIV in a nationally-representative sample of

married Indian women tested for the infection.

The researchers analysed data on 28,139 women as part of national family health

survey 2005-2006.

Approximately one-third of the women (35.49%) reported experiencing physical

IPV, with or without sexual violence, from husbands. About one-fourth (27..8%)

reported experiencing physical IPV without sexual violence, while 7.68% reported

both.

Approximately one in 450 women (0.22%) tested positive for HIV. Those

experiencing both physical and sexual violence from husbands demonstrated

elevated HIV infection prevalence.

The findings also indicated that physical and sexual violence combined related

to increased HIV prevalence, while physical violence alone did not.

The reasons include physical trauma resulting from forced sex. Men’s risk

behaviour and women’s lack of control over sex or sexual protection have also

been blamed.

Previous studies have indicated that elevated sexual risk behaviour of husbands

(e.g. unprotected extramarital sex, multiple sex partners, sex with commercial

workers, no condom use or forced unprotected sex) is linked with

sexually-transmitted infections (STIs) among abusive men, which further causes

STIs among women due to IPV.

Married Indian women who experienced both physical and sexual IPV showed four

times greater HIV infection prevalence than non-abused women.

p_vineeta@...

http://www.dnaindia.com/report.asp?newsid=1182800

[Guest guest]

Editors note: Thanks Dr. Nabeel for providing the reference to the article. An

abstract of the paper follows Dr. Nabeel's eLetter. A pdf copy of the full

article is available with the editor]

Dear Editor,

The original article referred by Ms Vinita in the DNA article shared by

AIDS-India forum by Ms. is from the Journal of the American Medical

Association (JAMA). Please find details below.

The American Medical Association (AMA) brings out two flagship journals - the

JAMA and the ls of Internal Medicine.   They have dealt with these topics in

the past also whcih can be found in the archives / topic collection section of

their website.

Intimate Partner Violence and HIV Infection Among Married Indian Women

http://jama.ama-assn.org/cgi/content/short/300/6/703

Jay G. Silverman, PhD; Michele R. Decker, ScD; Niranjan Saggurti, PhD; Donta

Balaiah, PhD; Anita Raj, PhD

JAMA. 2008;300(6):703-710.

Hope this is helpful.

Regards,

Dr.Nabeel.M.K.

e-mail:<drnabeelmk@...>

______________________

Intimate Partner Violence and HIV Infection Among Married Indian Women

Jay G. Silverman, PhD; Michele R. Decker, ScD; Niranjan Saggurti, PhD; Donta

Balaiah, PhD; Anita Raj, PhD

JAMA. 2008;300(6):703-710.

Context Despite reductions in prevalence of human immunodeficiency virus (HIV)

infection among the general population of India, women account for a rising

percentage of all HIV cases with husbands' risk behavior described as the major

source of women's infection. Intimate partner violence (IPV) has been described

as being associated with heterosexual transmission of HIV to women in India and

elsewhere.

Objective To assess the relationship between experiencing IPV and the

occurrence of HIV infection in a nationally representative sample of married

Indian women tested for HIV.

Design, Setting, and Participants The Indian National Family Health Survey 3

was conducted across all Indian states in 2005 through 2006. The nationally

representative sample included 124 385 married women; analyses conducted in 2007

and 2008 were limited to 28 139 married women who provided IPV data and HIV test

results via systematic

selection into respective subsamples.

Main Outcome Measures Prevalence estimates of lifetime IPV and HIV infection

were calculated and demographic differences assessed.

Intimate partner violence was conceptualized as physical violence with or

without sexual violence and then was further categorized as physical violence

only vs physical and sexual violence. Regression models were used to estimate

the odds ratios (ORs) and 95% confidence intervals (CIs) for HIV infection among

Indian women based on experiences of IPV after adjusting for demographics and

women's HIV risk behaviors.

Results One-third of married Indian women (35.49%) reported experiencing

physical IPV with or without sexual violence from their husbands; 7.68% reported

both physical and sexual IPV, and 27.80% reported experiencing physical IPV in

the absence of sexual violence. Approximately 1 in 450 women (0.22%) tested

positive for HIV. In adjusted models, married Indian women experiencing both

physical and sexual violence from husbands demonstrated elevated HIV infection

prevalence vs those not experiencing IPV (0.73% vs 0.19%; adjusted OR, 3.92; 95%

CI, 1.41-10.94; P = .01). Physical IPV alone was not associated with risk of HIV

infection. Women's personal sexual risk behaviors were not associated with HIV

infection.

Conclusions Among married Indian women, physical violence combined with sexual

violence from husbands was associated with an increased prevalence of HIV

infection. Prevention of IPV may augment efforts to reduce the spread of

HIV/AIDS.

Author Affiliations: Department of Society, Human Development and Health,

Harvard School of Public Health, Boston, Massachusetts (Drs Silverman and

Decker); Population Council, New Delhi, India (Dr Saggurti); National Institute

for Research in Reproductive Health, Indian Council for Medical Research,

Mumbai, India (Dr Balaiah); and Department of Social and Behavioral Sciences,

Boston University School of Public Health, Boston (Dr Raj).