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Physical and Sexual Violence Predictors: 20 Years of the Women's Interagency HIV Study Cohort.
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American journal of preventive medicine
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Publication Date
2016-08-29
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Publication Volume
51
Publication Issue
5
Publication Begin
731
Publication End
742
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Abstract
Introduction: Gender-based violence (GBV) threatens women's health and safety. Few prospective studies examine physical and sexual violence predictors. Baseline/index GBV history and polyvictimization (intimate partner violence, non-partner sexual assault, and childhood sexual abuse) were characterized. Predictors of physical and sexual violence were evaluated over follow-up.
Methods: HIV-infected and uninfected participants (n=2,838) in the Women's Interagency HIV Study provided GBV history; 2,669 participants contributed 26,363 person years of follow-up from 1994 to 2014. In 2015-2016, multivariate log-binomial/Poisson regression models examined violence predictors, including GBV history, substance use, HIV status, and transactional sex.
Results: Overall, 61% reported index GBV history; over follow-up, 10% reported sexual and 21% reported physical violence. Having experienced all three forms of past GBV posed the greatest risk (adjusted incidence rate ratio [AIRR]=2.23, 95% CI=1.57, 3.19; AIRR=3.17, 95% CI=1.89, 5.31). Time-varying risk factors included recent transactional sex (AIRR=1.29, 95% CI=1.03, 1.61; AIRR=2.98, 95% CI=2.12, 4.19), low income (AIRR=1.22, 95% CI=1.01, 1.45; AIRR=1.38, 95% CI=1.03, 1.85), and marijuana use (AIRR=1.43, 95% CI=1.22, 1.68; AIRR=1.57, 95% CI=1.19, 2.08). For physical violence, time-varying risk factors additionally included housing instability (AIRR=1.37, 95% CI=1.15, 1.62); unemployment (AIRR=1.38, 95% CI=1.14, 1.67); exceeding seven drinks/week (AIRR=1.44, 95% CI=1.21, 1.71); and use of crack, cocaine, or heroin (AIRR=1.76, 95% CI=1.46, 2.11).
Conclusions: Urban women living with HIV and their uninfected counterparts face sustained GBV risk. Past experiences of violence create sustained risk. Trauma-informed care, and addressing polyvictimization, structural inequality, transactional sex, and substance use treatment, can improve women's safety.
Methods: HIV-infected and uninfected participants (n=2,838) in the Women's Interagency HIV Study provided GBV history; 2,669 participants contributed 26,363 person years of follow-up from 1994 to 2014. In 2015-2016, multivariate log-binomial/Poisson regression models examined violence predictors, including GBV history, substance use, HIV status, and transactional sex.
Results: Overall, 61% reported index GBV history; over follow-up, 10% reported sexual and 21% reported physical violence. Having experienced all three forms of past GBV posed the greatest risk (adjusted incidence rate ratio [AIRR]=2.23, 95% CI=1.57, 3.19; AIRR=3.17, 95% CI=1.89, 5.31). Time-varying risk factors included recent transactional sex (AIRR=1.29, 95% CI=1.03, 1.61; AIRR=2.98, 95% CI=2.12, 4.19), low income (AIRR=1.22, 95% CI=1.01, 1.45; AIRR=1.38, 95% CI=1.03, 1.85), and marijuana use (AIRR=1.43, 95% CI=1.22, 1.68; AIRR=1.57, 95% CI=1.19, 2.08). For physical violence, time-varying risk factors additionally included housing instability (AIRR=1.37, 95% CI=1.15, 1.62); unemployment (AIRR=1.38, 95% CI=1.14, 1.67); exceeding seven drinks/week (AIRR=1.44, 95% CI=1.21, 1.71); and use of crack, cocaine, or heroin (AIRR=1.76, 95% CI=1.46, 2.11).
Conclusions: Urban women living with HIV and their uninfected counterparts face sustained GBV risk. Past experiences of violence create sustained risk. Trauma-informed care, and addressing polyvictimization, structural inequality, transactional sex, and substance use treatment, can improve women's safety.
Citation
Decker MR, Benning L, Weber KM, Sherman SG, Adedimeji A, Wilson TE, Cohen J, Plankey MW, Cohen MH, Golub ET. Physical and Sexual Violence Predictors: 20 Years of the Women's Interagency HIV Study Cohort. Am J Prev Med. 2016 Nov;51(5):731-742. doi: 10.1016/j.amepre.2016.07.005. Epub 2016 Aug 29. PMID: 27595175; PMCID: PMC5360180.