Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother‐to‐child transmission

作者：Abigail M. Hatcher, Nataly Woollett, Christina Pallitto, Keneuoe Mokoatle, Heidi Stöckl, Catherine MacPhail, Sinead Delany‐Moretlwe, Claudı́a Garcia‐Moreno · 发表于：Journal of the International AIDS Society · 年份：2014 · DOI：10.7448/ias.17.1.19233 · 被引用次数：94 · 研究领域：Intimate Partner and Family Violence、Adolescent Sexual and Reproductive Health、HIV/AIDS Research and Interventions

INTRODUCTION: Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. METHODS: We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team-based approach to thematic coding. FINDINGS: We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis during pregnancy, and subsequent partner disclosure, were noted as a common trigger of IPV. Disclosure leads to violence because it causes relationship conflict, usually related to perceived infidelity and the notion that women are "bringing" the disease into the relationship. IPV worsened HIV-related health through poor PMTCT adherence, since taking medication or accessing health services might unintentionally alert male partners of the women's HIV status. IPV also impacted on HIV-related health via ...