Diagnosis and disclosure of HIV status : Implications for women’s risk of physical partner violence in the postpartum period

<p>Introduction— This study prospectively examined whether HIV leads to elevated risk for intimate partner violence (IPV) for women, and how this risk varies depending on HIV status disclosure to a partner. Methods— We ran a series of logistic regression models using data from 1092 pregnant and postpartum women enrolled in an RCT in Durban, South Africa, The first model assessed whether baseline HIV-status predicted 14-week postpartum physical IPV, controlling for baseline physical IPV, disclosure to partner, demographic and study covariates. Model 2 added the interaction between HIV status and disclosure. Results— HIV was not associated with 14-week physical IPV in the main effects model adjusted odds ratio (AOR) 1.34, 95% CI: .88 - 2.05). However, there was a statistically significant positive interaction between HIV and disclosure, (AOR 0.22, 95% CI: .05-.96). Among women who disclosed their HIV status, HIV was not significantly associated with 14-week IPV (AOR 1.12; 95% CI 0.71-1.89). However, among women who had not disclosed, the odds of reporting IPV at 14 weeks was 5.15 times higher for HIV-positive women as compared to HIV-negative women (95% CI: 1.25-21.00). Discussion— While we established that HIV does not increase incidence of IPV for all HIV-positive women, we found an elevated risk of IPV among the HIV-positive women who chose not to disclose their status to their partner. Non-disclosure is likely a marker for other problematic aspects of the relationship, and counselors should either find alternative safe options for disclosure or support women’s decisions not to disclose.</p>