Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis
Abstract Background Intimate partner violence (IPV) is widespread in the WHO African region with generalised HIV epidemics and may contribute to ongoing HIV transmission through its associations with behaviours associated with HIV acquisition risk and low use of prevention methods particularly in ma...
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2024-11-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-024-03428-x |
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| author | Alexandra A. Cordeiro Louisa Moorhouse Tawanda Dadirai Rufurwokuda Maswera Angela Y. Chang Constance Nyamukapa Simon Gregson |
| author_facet | Alexandra A. Cordeiro Louisa Moorhouse Tawanda Dadirai Rufurwokuda Maswera Angela Y. Chang Constance Nyamukapa Simon Gregson |
| author_sort | Alexandra A. Cordeiro |
| collection | DOAJ |
| description | Abstract Background Intimate partner violence (IPV) is widespread in the WHO African region with generalised HIV epidemics and may contribute to ongoing HIV transmission through its associations with behaviours associated with HIV acquisition risk and low use of prevention methods particularly in marital relationships. Methods We conducted a male condom HIV prevention cascade analysis using data from a general-population survey in Manicaland, Zimbabwe (July 2018-December 2019) to develop an understanding of how interventions that reduce IPV might be built upon to also reduce HIV incidence. Multivariable logistic regression was used to measure associations between currently-married HIV-negative women’s experience of IPV and: (1) being in the priority population for HIV prevention methods (i.e. married women engaging in behaviours associated with HIV acquisition risk or with a spouse who engages in similar behaviours or is living with HIV), and (2) male condom use by women in this priority population. Male condom HIV prevention cascades, with explanatory barriers for gaps between successive cascade bars (motivation, access and effective use), were compared for women in the priority population reporting and not reporting IPV. Results We found a positive association between IPV and being in the priority population for HIV prevention methods (72.3% versus 58.5%; AOR = 2.26, 95% CI:1.74–2.93). Condom use was low (< 15%) for women in the priority population and did not differ between those reporting and not reporting IPV. The HIV prevention cascades for women reporting and not reporting IPV were similar; both showing large gaps in motivation and capacity to use male condoms effectively. Women reporting motivation and access to male condoms were more likely to report their partner being a barrier to condom use if they experienced IPV (84.8% versus 75.5%; AOR = 2.25, 95% CI:1.17–4.31). Conclusion The findings of this study support the case for trials of integrated IPV/HIV prevention interventions that are tailored to improve HIV risk perception among HIV-negative married women and to make condom provision more acceptable for this group. |
| format | Article |
| id | doaj-art-c98376c3e22e494bbb686844cf8230a8 |
| institution | OA Journals |
| issn | 1472-6874 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj-art-c98376c3e22e494bbb686844cf8230a82025-08-20T02:38:39ZengBMCBMC Women's Health1472-68742024-11-0124111410.1186/s12905-024-03428-xIntimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysisAlexandra A. Cordeiro0Louisa Moorhouse1Tawanda Dadirai2Rufurwokuda Maswera3Angela Y. Chang4Constance Nyamukapa5Simon Gregson6MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College LondonMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College LondonBiomedical Research and Training InstituteBiomedical Research and Training InstituteDanish Institute for Advanced Study, University of Southern DenmarkMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College LondonMRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College LondonAbstract Background Intimate partner violence (IPV) is widespread in the WHO African region with generalised HIV epidemics and may contribute to ongoing HIV transmission through its associations with behaviours associated with HIV acquisition risk and low use of prevention methods particularly in marital relationships. Methods We conducted a male condom HIV prevention cascade analysis using data from a general-population survey in Manicaland, Zimbabwe (July 2018-December 2019) to develop an understanding of how interventions that reduce IPV might be built upon to also reduce HIV incidence. Multivariable logistic regression was used to measure associations between currently-married HIV-negative women’s experience of IPV and: (1) being in the priority population for HIV prevention methods (i.e. married women engaging in behaviours associated with HIV acquisition risk or with a spouse who engages in similar behaviours or is living with HIV), and (2) male condom use by women in this priority population. Male condom HIV prevention cascades, with explanatory barriers for gaps between successive cascade bars (motivation, access and effective use), were compared for women in the priority population reporting and not reporting IPV. Results We found a positive association between IPV and being in the priority population for HIV prevention methods (72.3% versus 58.5%; AOR = 2.26, 95% CI:1.74–2.93). Condom use was low (< 15%) for women in the priority population and did not differ between those reporting and not reporting IPV. The HIV prevention cascades for women reporting and not reporting IPV were similar; both showing large gaps in motivation and capacity to use male condoms effectively. Women reporting motivation and access to male condoms were more likely to report their partner being a barrier to condom use if they experienced IPV (84.8% versus 75.5%; AOR = 2.25, 95% CI:1.17–4.31). Conclusion The findings of this study support the case for trials of integrated IPV/HIV prevention interventions that are tailored to improve HIV risk perception among HIV-negative married women and to make condom provision more acceptable for this group.https://doi.org/10.1186/s12905-024-03428-xIntimate partner violenceHIV prevention cascadehealth education and promotioncommunity based survey |
| spellingShingle | Alexandra A. Cordeiro Louisa Moorhouse Tawanda Dadirai Rufurwokuda Maswera Angela Y. Chang Constance Nyamukapa Simon Gregson Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis BMC Women's Health Intimate partner violence HIV prevention cascade health education and promotion community based survey |
| title | Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis |
| title_full | Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis |
| title_fullStr | Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis |
| title_full_unstemmed | Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis |
| title_short | Intimate partner violence, behaviours associated with risk of HIV acquisition and condom use in married women in Manicaland, East Zimbabwe: An HIV prevention cascade analysis |
| title_sort | intimate partner violence behaviours associated with risk of hiv acquisition and condom use in married women in manicaland east zimbabwe an hiv prevention cascade analysis |
| topic | Intimate partner violence HIV prevention cascade health education and promotion community based survey |
| url | https://doi.org/10.1186/s12905-024-03428-x |
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