Abstract: Gender-Based Violence Among HIV-Positive Women in Kazakhstan: Prevalence, Types, and Risk and Protective Factors (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

Schedule:

Saturday, January 13, 2018: 4:00 PM

Independence BR B (ML 4) (Marriott Marquis Washington DC)

* noted as presenting author

Tina Jiwatram-Negron, PhD, Postdoctoral Research Fellow, University of Michigan-Ann Arbor, Ann Arbor, MI

Sholpan Primbetova, MSW, Deputy Regional Director, Columbia University Global Health Research Center of Central Asia, Almaty, Kazakhstan

Assel Terlikbayeva, MD, Regional Director, Columbia University Global Health Research Center of Central Asia, Almaty, Kazakhstan

Elena Bilokon, Organization Head, Kazakhstan Association of Women Living with HIV, Temirtau, Kazakhstan

Lyubov Chubukova, Community Mobilization Officer, Kazakhstan Union of People Living with HIV, Almaty, Kazakhstan

Linara Akhmedzyanova, Consultant, Kazakhstan Association of Women Living with HIV, Istanbul, Turkey

Nabila El-Bassel, PhD, Professor, Columbia University, New York, NY

Background and Purpose: Globally, 35% of women have experienced some form of gender-based violence (GBV). Despite increasing efforts to document GBV, limited surveillance data exists across Central Asia, a region experiencing a growing HIV epidemic. Data from other low and middle-income countries indicate high levels of stigma, discrimination, and violence against HIV-positive women. The data suggest an urgent need for epidemiological data on the scope of GBV among HIV-positive women in Central Asia, and associated risk and protective factors that may inform the development of gender-responsive programming. Guided by the ecological systems perspective, this paper examines the prevalence of GBV among a sample of HIV-positive women in Kazakhstan, the largest of the Central Asian countries, and associated multi-level risk and protective factors.

Methods: This paper uses data from a cross-sectional survey administered to 249 HIV-positive women across five areas of Kazakhstan. Participants were asked a range of questions pertaining to their socio-demographics, substance use, mental health, social support, partner risk behaviors, among others. Using a modified version of the Revised Conflict Tactics Scale (CTS-2), participants also responded to a series of questions about their lifetime exposure to intimate and non-intimate partner violence. Using descriptive statistics, this paper examines lifetime prevalence of intimate partner and non-intimate partner violence (collectively, GBV). Then, using multivariate logistic regression analyses, this paper examines the individual, interpersonal, and socio-structural factors that exacerbate or attenuate risk of GBV.

Results: Findings indicated high prevalence of lifetime intimate partner violence (52%) and non-intimate partner violence (30%) among this sample of HIV-positive women. Together, 60% of the women in the sample experienced violence by an intimate or non-intimate partner (GBV). Nearly 13% of women in the sample reported GBV in relation to their HIV-positive status. Adjusted multivariate analyses indicated critical associations between GBV and depression (p<.01), individual and partner risk behaviors (sexual and drug) (p<.01), social support (p<0.05), food insecurity (p<0.001), and HIV-related stigma (p<.001).

Conclusions and Implications: The findings suggest an urgent need for additional epidemiological and systematic surveillance of violence among HIV-positive women in Central Asia. Findings from this study also point to a number of practical implications including expansion of screening tools to assess violence by a range of perpetrators and the importance of reducing HIV-related stigma and increasing access to basic resources, social support, services that address sexual and drug risk. Findings also underscore the need to develop and expand GBV services for HIV-positive women who experience GBV, which are currently scarce.