Exploring the Linkages between Domestic Violence and HIV

Clinic-based studies routinely report a higher prevalence of domestic violence among HIV-positive women compared to HIV-negative women. This same association is not consistently found in population-based cross-sectional studies. The usual interpretation, if an association is detected, is that domestic violence leads to an increased risk of HIV. Yet a direct effect is unlikely. If domestic violence increases the odds of a woman having HIV, it must do so indirectly through her own risk behaviors, those of her partner, or her partner’s HIV status. Population-based studies seldom explicitly articulate and model the intervening paths through which domestic violence may influence HIV status; Variation in their findings may well depend on variations in the conceptualization of violence, analytic methodologies, and included covariates. Additionally, most studies are based on women’s data with limited information on partners’ HIV status and risk behaviors. This paper clarifies the ways in which domestic violence contribute to women’s HIV status, using recent DHS surveys from five Sub-Saharan countries with data on domestic violence, HIV test results and risk factors for both partners of married/in-union matched couples and guided by a conceptual framework depicting possible pathways by which violence could indirectly effect HIV status.