ABSTRACT

Intimate partner violence (IPV) and suicidality are intersecting social problems. However, limited studies have examined IPV and suicidality among socially marginalized women, such as women living with HIV (WLHIV), or in low- and middle-income countries, where social services vary widely. This paper seeks to fill this gap by exploring the association between IPV and suicidal ideation among a sample of WLHIV. A cross-sectional survey was administered to 249 WLHIV across five regions of Kazakhstan, Central Asia. Both IPV (50.2%) and suicidal ideation (40.5%) were common. Adjusted multivariate logistic regression analyses indicated critical associations between all types of IPV and suicidal ideation: verbal (aOR = 2.5, p <.05); psychological (aOR = 3.3, p <.01); physical (aOR = 2.3, p <.05); sexual (aOR = 3.6, p <.01); injurious (aOR = 4.6, p <.01); and any IPV (aOR = 2.3, p <.05). Consistently significant covariates included marital status, social support, injection drug use, and HIV-related stigma (p <.05). Findings suggest a need to examine the crossover pathways and rates of IPV, HIV, and suicidality. Implications include the need for increased capacity building among providers to address these co-occurring problems through comprehensive assessments, safety planning, and linkage to care.

摘要

亲密伴侣暴力 (IPV) 和自杀是相互交叉的社会问题。然而，有限的研究调查了社会边缘化女性（例如感染 HIV 的女性 (WLHIV) 或社会服务差异很大的中低收入国家）的 IPV 和自杀倾向。本文试图通过在 WLHIV 样本中探索 IPV 与自杀意念之间的关联来填补这一空白。对哈萨克斯坦和中亚五个地区的 249 名 WLHIV 进行了横断面调查。IPV (50.2%) 和自杀意念 (40.5%) 都很常见。调整后的多变量逻辑回归分析表明所有类型的 IPV 与自杀意念之间存在重要关联：口头（a OR  = 2.5，p <.05）；心理（OR  = 3.3，p <.01)；物理 (a OR  = 2.3, p <.05); 性（a OR  = 3.6，p <.01）；有害（a OR  = 4.6，p <.01）；和任何 IPV（a OR  = 2.3，p <.05）。持续显着的协变量包括婚姻状况、社会支持、注射吸毒和 HIV 相关污名 ( p <.05)。研究结果表明需要检查 IPV、HIV 和自杀的交叉途径和比率。影响包括需要加强提供者之间的能力建设，以通过综合评估、安全规划和与护理的联系来解决这些共同发生的问题。