Abstract

Intimate partner violence and HIV remain significant health challenges among women living with HIV. Intimate partner violence has been linked to negative health outcomes and poorer HIV care engagement. This study examined intimate partner violence among Ugandan women living with HIV, their experiences disclosing such violence and how culturally normative factors affected disclosure-related outcomes. In a mixed-methods study conducted in Uganda in 2018, 168 women participated in interviewer-administered surveys; a sub-set who reported experiencing intimate partner violence participated in in-depth interviews (IDIs). Intimate partner violence was prevalent among women in the sample (68.0%); almost half experienced emotional violence (45.2%), while a smaller proportion had experienced physical (32.1%) and/or sexual violence (19.6%). Most women living with HIV (61.8%) had disclosed their experience of intimate partner violence to someone. Women who experienced intimate partner violence had higher odds of disclosure if they feared their partner and perpetrated violence against their partner. Thematic analysis of IDIs revealed enduring violence and blaming alcohol for men’s perpetration of violence. Traditional cultural and gender norms, especially concerning motherhood and partnership, influenced women's experiences of intimate partner violence and disclosure. Multi-sectoral responses to challenge and reform cultural norms that perpetuate violence are needed, including mobilising key stakeholders (e.g. family, community, policy-makers) to serve as catalysts for change and encourage resource- and safety-seeking for women living with HIV to escape violence.

摘要

亲密伴侣的暴力行为和艾滋病毒仍然是艾滋病毒携带者女性面临的重大健康挑战。亲密伴侣的暴力行为已与负面的健康结果和较差的艾滋病毒护理工作联系在一起。这项研究调查了感染艾滋病毒的乌干达妇女中亲密伴侣的暴力行为，揭示此类暴力行为的经历以及文化规范因素如何影响与披露相关的结果。在2018年在乌干达进行的混合方法研究中，有168名妇女参加了由访调员管理的调查; 据报道有伴侣经历过亲密暴力的亚人群参加了深度访谈（IDI）。样本中女性中普遍存在亲密伴侣暴力（68.0％）；几乎一半的人经历过情感暴力（45.2％），而一小部分经历过身体暴力（32.1％）和/或性暴力（19.6％）。大多数感染艾滋病毒的妇女（61.8％）向某人透露了亲密伴侣暴力的经历。遭受亲密伴侣暴力的妇女如果担心自己的伴侣并对其伴侣实施暴力，则更有可能公开信息。对IDI的主题分析显示，暴力持续存在，男人将暴力归咎于酗酒。传统的文化和性别规范，特别是关于母性和伙伴关系的规范，影响了妇女亲密伴侣暴力和公开的经历。需要采取多部门对策来挑战和改革使暴力永久化的文化规范，包括动员关键的利益相关者（例如家庭，社区，决策者）来推动变革，并鼓励艾滋病毒携带妇女寻求资源和安全方面的知识，逃脱暴力。8％）向某人透露了他们亲密伴侣暴力的经历。遭受亲密伴侣暴力的妇女如果担心自己的伴侣并对其伴侣实施暴力，则更有可能公开信息。对IDI的主题分析显示，暴力持续存在，男人将暴力归咎于酗酒。传统的文化和性别规范，特别是关于母性和伙伴关系的规范，影响了妇女亲密伴侣暴力和公开的经历。需要采取多部门对策来挑战和改革使暴力永久化的文化规范，包括动员关键的利益相关者（例如家庭，社区，决策者）来推动变革，并鼓励艾滋病毒携带妇女寻求资源和安全方面的知识，逃脱暴力。8％）向某人透露了他们亲密伴侣暴力的经历。遭受亲密伴侣暴力的妇女如果担心自己的伴侣并对其伴侣实施暴力，则更有可能公开信息。对IDI的主题分析显示，暴力持续存在，男人将暴力归咎于酗酒。传统的文化和性别规范，特别是关于母性和伙伴关系的规范，影响了妇女亲密伴侣暴力和公开的经历。需要采取多部门对策来挑战和改革使暴力永久化的文化规范，包括动员关键的利益相关者（例如家庭，社区，决策者）来推动变革，并鼓励艾滋病毒携带妇女寻求资源和安全方面的知识，逃脱暴力。