Abuse By Husbands Linked To Higher HIV Rate Of Married Women In India

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Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs
Article Date: 14 Aug 2008 - 0:00 PDT

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Researchers form Harvard and India have found that married Indian women who are physically and sexually abused by their husbands have an increased risk of HIV infection compared with women who are not abused by their husbands. The results of the study are published in the August 13 issue of JAMA.

Jay G. Silverman, Ph.D. (Harvard School of Public Health, Boston) and colleagues write that, "India is home to approximately 2.5 million people living with human immunodeficiency virus (HIV), the third largest number of cases of any country in the world, and is recognized as the source of increasing HIV prevalence among its South Asian neighbors." They add: "Despite reductions in prevalence of … infection among the general population of India, women account for a rising percentage of all HIV cases, with husbands' risk behavior described as the major source of women's infection. Intimate partner violence (IPV) has been described as being associated with heterosexual transmission of HIV to women in India and elsewhere."

To assess the relationship between HIV occurrence and IPV, the researchers conducted a study in 2007 and 2008 using a nationally representative sample of married Indian women who had received HIV tests. The sample consisted of 28,139 married women who, during 2005 and 2006, released IPV data and HIV test results as part of a national Indian family health survey.

The researchers found that 35.49% of married Indian women have experienced physical IPV - with or without sexual violence - from their husbands. About one quarter of the women reported sexually violent IPV and 7.68% reported both physical and sexual IPV. The sample HIV-positive rate was about one in 450 women - or 0.22%.

The authors write that, "In this first national population-based study of the relationship of husbands' violence against wives to wives' HIV infection status (as indicated via diagnostic testing), married Indian women who experienced both physical and sexual IPV demonstrated an HIV infection prevalence approximately four times greater than that of non-abused women."

The personal sexual risk behaviors of women - such as condom use and multiple partners - were not associated with HIV infection prevalence, and physical IPV alone was not associated with the risk of HIV infection.

"Prevention of IPV may augment efforts to reduce the spread of HIV/AIDS," conclude the authors. "Findings of the present study, based on both the large population-based sample and the use of standard diagnostic testing for HIV infection, should serve to confirm the nature of this relationship and move public health policy-makers and practitioners to increase recognition of IPV as a critically important target in the global fight against HIV/AIDS."

Intimate Partner Violence and HIV Infection Among Married Indian Women
Jay G. Silverman, PhD; Michele R. Decker, ScD; Niranjan Saggurti, PhD; Donta Balaiah, PhD; Anita Raj, PhD
JAMA(2008). 300[6]: pp. 703-710.
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Written by: Peter M Crosta
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