HIV-Serostatus Disclosure and Prevalence of Intimate Partner Violence Among HIV-Infected Women Attending Care and Treatment Centers in Dar Es Salaam, Tanzania

Abstract

Background Intimate partner violence (IPV) against women is a serious public health problem worldwide indicating it is a pressing health and human rights concern. Systematic reviews indicate that there is wide variation in magnitude and distribution of IPV. Sub-Saharan Africa, however, appears to have a double burden of HIV-infection and IPV. The association between HIV serostatus disclosure with IPV is not well understood in our setting. Objectives The objectives of this study were: first, to determine the prevalence of IPV among women who attended care and treatment centers in Ilala Municipality, Dar es Salaam. Second, to determine whether there was an association between HIV-serostatus disclosure with IPV. Materials and Methods We conducted a cross-sectional study in Ilala Municipal, Dar es Salaam from March to April 2014. Using interviewer- administered questionnaires we assessed the prevalence and risk factors for IPV among 384 HIV-infected women attending care and treatment facilities, aged 15 years or more, and in intimate relationship. Data were recorded on questionnaires, and the information was entered to a computer and analyzed using Statistical Package for social Sciences (SPSS) software version 15. Results The main finding was that the prevalence of IPV among HIV-infected women was 39.6% (152/384) (95% Confidence Interval [CI] = 33.4-45.8). Three quarters (75.4%) of the women reported that they had disclosed their HIV-serostatus to their partners. Compared to women who did not disclose their HIV-serostatus, those who disclosed were significantly more likely to experience IPV (Adjusted Odds Ratio (AOR) = 2.34, 95% CI = 1.20-4.56); (P = 0.01). Other factors found to be associated with IPV included whether the partner reported that he had other sexual partner(s) [AOR = 1.61, 95% CI = 1.25-2.06 (P < 0.001)] and consumed alcohol [AOR] = 1.88; 95% CI = 1.18-2.97, P = 0.01.

Conclusion Among women who are HIV-infected, the prevalence of IPV in the previous twelve months was high. Our findings showed that disclosure of HIV-serostatus to partner, and if the partner consumed alcohol or had other sexual partners were significantly associated with IPV. Recommendations The study recommended that routine screening of IPV among HIV infected women should be made a policy of the country. Health care workers at all levels of health facilities should also be sensitized to ask questions on IPV when they encounter HIV- infected women. This should allow the health system to identify and intervene in situations of abuse. Couple counseling and testing should also be emphasized to reduce the likelihood of women experiencing violence from their partners. On the other hand women should not be forced to disclose their HIV-serostatus to their partners. The Ministry of health should focus on interventions that aim at preventing IPV at communities. Interventions aiming at addressing risk factors for IPV should particularly be the main focus.