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

亲密伴侣暴力和 HIV 仍然是 HIV 感染妇女面临的重大健康挑战。亲密伴侣暴力与负面的健康结果和较差的 HIV 护理参与有关。本研究调查了乌干达 HIV 感染妇女的亲密伴侣暴力行为、她们披露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 年在乌干达进行的一项混合方法研究中，有 168 名女性参与了采访者管理的调查；报告遭受亲密伴侣暴力的子集参加了深度访谈（IDI）。样本中的女性普遍存在亲密伴侣暴力行为（68.0%）；几乎一半人经历过情感暴力（45.2%），而较小比例的人经历过身体暴力（32.1%）和/或性暴力（19.6%）。大多数感染艾滋病毒的女性（61.8%）曾向某人披露过她们遭受亲密伴侣暴力的经历。经历过亲密伴侣暴力的女性如果害怕自己的伴侣并对伴侣施暴，她们的披露几率会更高。对 IDI 的专题分析揭示了持久的暴力行为，并将男性的暴力行为归咎于酒精。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，影响了女性遭受亲密伴侣暴力和披露的经历。需要多部门应对挑战和改革使暴力长期存在的文化规范，包括动员关键利益相关者（例如家庭、社区、决策者）作为变革的催化剂，并鼓励感染艾滋病毒的妇女寻求资源和安全逃避暴力。8%）向某人披露了他们遭受亲密伴侣暴力的经历。经历过亲密伴侣暴力的女性如果害怕自己的伴侣并对伴侣施暴，她们的披露几率会更高。对 IDI 的专题分析揭示了持久的暴力行为，并将男性的暴力行为归咎于酒精。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，影响了女性遭受亲密伴侣暴力和披露的经历。需要多部门应对挑战和改革使暴力长期存在的文化规范，包括动员关键利益相关者（例如家庭、社区、决策者）作为变革的催化剂，并鼓励感染艾滋病毒的妇女寻求资源和安全逃避暴力。8%）向某人披露了他们遭受亲密伴侣暴力的经历。经历过亲密伴侣暴力的女性如果害怕自己的伴侣并对伴侣施暴，她们的披露几率会更高。对 IDI 的专题分析揭示了持久的暴力行为，并将男性的暴力行为归咎于酒精。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，影响了女性遭受亲密伴侣暴力和披露的经历。需要多部门应对挑战和改革使暴力长期存在的文化规范，包括动员关键利益相关者（例如家庭、社区、决策者）作为变革的催化剂，并鼓励感染艾滋病毒的妇女寻求资源和安全逃避暴力。