HIV this week
Nigeria: Intimate partner violence and PMTCT
This study aimed to evaluate the prevalence and correlates of intimate partner violence among HIV-positive pregnant Nigerian women. The design was a cross-sectional study using an anonymous semi-structured interviewer-administered questionnaire. The study population was 305 HIV-positive women receiving antenatal care at the University of Benin Teaching Hospital, Nigeria, from June 2008 to December 2009. An anonymous semi-structured World Health Organization modified questionnaire, that elicited information on the experiences of intimate partner violence, was administered to the women by trained female interviewers.
Main outcome measures were prevalence, pattern and risk factors associated with experiencing intimate partner violence. The prevalence of intimate partner violence among the women was 32.5%, with psychological violence being the most common form of violence reported (27.5%) and physical violence the least reported (5.9%). Identified risk factors for experiencing violence were multiparity (Odds ratio 9.4; CI 1.23-71.33), respondents with an HIV-positive child (Odds ratio 9.2; CI 4.53-18.84), experience of violence before they were diagnosed HIV-positive (Odds ratio 44.4; 10.33-190.42) and women with partners without post-secondary education (Odds ratio 2.3; CI 1.40-3.91). Intimate partner violence is a prevalent public health problem among HIV-infected pregnant women in this community and it may hinder efforts to scale up prevention of mother-child transmission programmes, especially in developing countries. Screening for intimate partner violence to identify abused women should be incorporated into these programmes to offer these women optimal care.
The levels of intimate partner violence documented here call out for intervention. During their current pregnancy, 9.8% of women experienced sexual abuse (rape or coercion), 5.9% reported physical abuse (hitting, kicking, slapping, beating), and 27.5% received psychological abuse (threats, humiliating remarks and verbal abuse). In this Nigerian setting, risk factors included lower spousal education, having experienced violence before HIV diagnosis, having children already, and having an HIV-positive child. In addition to introducing standardised questions to screen for intimate partner violence during pregnancy in antenatal settings and supporting couples to address the psychological stressors of HIV diagnosis, programmes should ensure that the contraceptive needs of women living with HIV are met and that there are enabling conditions for active male engagement in sexual and reproductive health services.