Correlates of Intimate Partner Violence Among Young Women Engaged in Sex Work in Southern Uganda

Background: Intimate partner violence (IPV) is a significant global public health problem that results in high social and economic costs to individuals and communities.Globally, 27% of ever partnered women of ages 15-49 have experienced physical, sexual or psychological intimate partner violence (IPV) in their lifetime. Compared to women in the general population, women engaged in sex work (WESW) are more likely to experience physical, emotional, and sexual IPV. This study examines the correlates of IPV among young WESW with their intimate partners in Southern Uganda

Methods:We used baseline data from a 5-year NIH-funded randomized controlled study aimed at reducing HIV risks WESW in Southern Uganda. Women were eligible to participate in the study if they: 1) were at least 18 years old; 2) reported having engaged in vaginal or anal sexual intercourse in exchange for money, alcohol, or other goods in the preceding 30 days; and 3) reported at least one episode of unprotected sexual intercourse in the past 30 days with a paying, casual, or regular sexual partner. IPV was categorized into physical, sexual and emotional intimate partner violence, based on the WHO definition of IPV. To examine the correlates of IPV, we fitted separate multi-level mixed effects Poisson regression models corresponding to the three forms of IPV.

Results: Average age was 31.4 years, and 54% of the women reported being victims of at least one form of IPV from their intimate partners. Model one assessed correlates of sexual IPV. Being married women (β=0.71, 95% CI= 0.24, 1.17), divorced/separated/ widowed (β= 0.52, 95% CI= 0.02, 1.02), depressed (β=0.04, 95% CI= 0.02, 0.05), and having any STIs (β= 0.58, 95% CI= 0.14, 1.01) were associated with sexual IPV. Model two assessed correlates of physical IPV. Experience of childhood sexual abuse (β= 0.12, 95% CI=0.04, 0.19) was associated with an increase in physical IPV, and increasing age reduced its occurrence (β= -0.02, 95% CI= -0.04, -0.001). Finally, model three assessed emotional IPV. Women with higher education (β= 0.49, 95% CI=0.14, 0.85) and symptoms of depression (β=0.02, 95% CI=0.001, 0.04) had higher risks for emotional IPV.

Conclusion: For WESW, IPV presents an additional potential pathway for HIV and STIs acquisition and transmission through a lack of negotiating power for safe sex. Efforts to reduce violence against WESW should be prioritized as a strategy for enhancing the well-being of WESW.