Theory of Gender and Power: Intimate Partner Violence, HIV Status and Sexual Risk Behaviors in Haitian Women

Among women in Haiti, there are a number of factors, including intimate partner violence (IPV), childhood sexual abuse, and alcohol abuse that lead to increased vulnerability to STI/HIV and its sequelae. This study examined the factors associated with IPV and the associations between IPV and HIV in a sample of adult Haitian women. The current study is a secondary analysis of data collected from HIV+ and HIV- women attending the GHESKIO centers in Haiti. The measures include: Self-reported Questionnaire-20 (SRQ-20); Attitudes Towards Gender Roles; Partner Violence; Alcohol Use Disorders Identification Test (AUDIT); Partner Support; Sexual Relationship Power Scale (SRPS); Centers for Epidemiological Studies Depression Scale (CES-D); the State-Trait Anxiety Inventory (STAI); and, Vaginal Episode Equivalent (VEE). Descriptive statistics were used for demographic characteristics. Pearson correlations, t-Test, Generalized linear model, Logistic regressions, and Generalized linear mixed models were used for estimating the strength of associations. The mean (SD) age of the participants was 25.5 (5.4) years. Approximately 68.4% had some secondary school education and only 0.9% had a college or professional degree. The majority of participants (82.2%) had a partner, but did not live with them. Generalized linear mixed modelling showed that lack of family support (β = 0.28, p \u3c 0.05), history of childhood sexual abuse (β = 0.66, p \u3c 0.05), and traditional gender-based attitudes (β = 0.10, p \u3c 0.001) predicted major IPV. Results from logistic regression analysis showed that age at sexual debut (AOR: 0.745; 95% CI: 0.585, 0.948) and physical violence (AOR: 3.482; 95% CI: 2.316, 5.235) were significantly associated with HIV seropositive status. Generalized linear mixed modelling analysis showed that decreased relationship control subscale scores (β = -0.26, p \u3c 0.05) and alcohol use problems (β = 0.18, p \u3c 0.05) were significantly associated with high levels of risky sexual behaviors over time. In summary, a history of IPV was significantly associated with traditional gender based attitudes, history of childhood sexual abuse, and lack of family support. History of IPV and age of first sexual experience were significantly associated with HIV seropositive status. Finally, relationship control and alcohol use problems were significantly associated with sexual risk behavior. These findings indicate potential areas of further study and intervention among Haitian women