Intimate partner violence and HIV infection among married Indian women
Silverman,Jay G.; Decker,Michele R.; Saggurti,Niranjan; Balaiah,Donta; Raj,Anita
Journal of the American Medical Association 300(6): 703-710
Publication date: 2008
Despite reductions in prevalence of human immunodeficiencyvirus (HIV) infection among the general population of India,women account for a rising percentage of all HIV cases withhusbands' risk behavior described as the major source of women'sinfection. Intimate partner violence (IPV) has been describedas being associated with heterosexual transmission of HIV towomen in India and elsewhere.
To assess the relationship between experiencingIPV and the occurrence of HIV infection in a nationally representativesample of married Indian women tested for HIV.
Design, Setting, and Participants
The Indian NationalFamily Health Survey 3 was conducted across all Indian statesin 2005 through 2006. The nationally representative sample included124 385 married women; analyses conducted in 2007 and 2008were limited to 28 139 married women who provided IPV dataand HIV test results via systematic selection into respectivesubsamples.
Main Outcome Measures
Prevalence estimates of lifetimeIPV and HIV infection were calculated and demographic differencesassessed. Intimate partner violence was conceptualized as physicalviolence with or without sexual violence and then was furthercategorized as physical violence only vs physical and sexualviolence. Regression models were used to estimate the odds ratios(ORs) and 95% confidence intervals (CIs) for HIV infection amongIndian women based on experiences of IPV after adjusting fordemographics and women's HIV risk behaviors.
One-third of married Indian women (35.49%) reportedexperiencing physical IPV with or without sexual violence fromtheir husbands; 7.68% reported both physical and sexual IPV,and 27.80% reported experiencing physical IPV in the absenceof sexual violence. Approximately 1 in 450 women (0.22%) testedpositive for HIV. In adjusted models, married Indian women experiencingboth physical and sexual violence from husbands demonstratedelevated HIV infection prevalence vs those not experiencingIPV (0.73% vs 0.19%; adjusted OR, 3.92; 95% CI, 1.41-10.94;P = .01). Physical IPV alone was not associated withrisk of HIV infection. Women's personal sexual risk behaviorswere not associated with HIV infection.
Among married Indian women, physical violencecombined with sexual violence from husbands was associated withan increased prevalence of HIV infection. Prevention of IPVmay augment efforts to reduce the spread of HIV/AIDS.