An Exploratory Study Examining the Prevalence of Intimate Partner Violence and HIV-Specific Forms of Abuse Among Women Living with HIV

Background and Purpose: Extensive research has shown that women living with HIV (WLHIV) with a history of intimate partner violence (IPV) often experience concomitant infections and have lower rates of viral suppression compared to women without a history of IPV. Qualitative research suggests that in addition to experiencing IPV, WLHIV may also experience other forms of abuse by partners (e.g. appointment sabotage) associated with their status which may further complicate their engagement and success in the HIV care continuum. Yet, limited research has examined how frequently HIV-specific forms of abuse by a partner occur alongside more traditionally measured experiences of IPV, which has implications for practice and treatment care prioritization. As such, the purpose of this paper is to examine the prevalence of different forms of IPV and HIV-specific forms of abuse and the relationship or co-occurrence between these different forms of abuse.

Methods: In 2023, 59 WLHIV, recruited from two hospital systems serving a racially and socioeconomically diverse patient population across two counties in a U.S. Southwestern state, were invited to complete a quantitative survey as part of a larger mixed methods study. IPV was measured using standard scales of physical, sexual, and emotional violence as well as technology-facilitated abuse and economic abuse. In the absence of a validated scale, a 17-item exploratory measure of HIV-related abuse was developed by the authors based on existing literature and qualitative interviews during the first phase of the study, yielding a strong Cronbach alpha of 0.87. Descriptive analyses were conducted to describe the sample and explore the overall prevalence, linkage, and psychometric properties of the measures.

Results: Participants were between 21-77 years old (M=54.29; SD=10.82), and most identified as Black/African American (37.29%), Caucasian/White (30.51%), or Hispanic/Latino (20.34%). A majority of participants were U.S. born (77.97%) and indicated either a high school degree/GED (33.90%) or attending some college (35.59%). Lifetime prevalence of IPV was higher than national estimates, with half of the sample experiencing emotional (52.54%) and/or physical (49.15%) IPV. Lifetime experience of economic (45.76%), technology-facilitated (37.29%), and/or sexual IPV (32.20%) were also high. While HIV-related abuse (32.20%) was less prevalent, it was the most likely form to have been experienced within the past 12-months. Examining correlations between different forms of abuse, HIV-related abuse was the least strongly correlated with the other forms of IPV (0.37 – 0.48); while other forms of IPV were more consistently correlated with one another (0.44-0.86).

Conclusions and Implications: The high prevalence of IPV and HIV-related abuse among WLHIV suggests the need to potentially broaden existing screening tools to more readily identify potentially non-correlated, but frequently occurring forms of abuse and develop intervention strategies that mitigate harm and improve engagement and success in the HIV care continuum. Findings also suggest the need for more expansive quantitative research among WLHIV, including validating measures to assess HIV-related abuse. Finally, research is needed to identify the unique ways that WLHIV experience IPV and HIV-related abuse and the mechanisms through which IPV and HIV-related abuse is perpetrated and impacts HIV-care outcomes.