Association between Intimate Partner Violence and HIV Infection among Married Indian Women in Theni District, Tamil Nadu, India

The prevalence of HIV infection among Indian women is on the rise accounting for nearly 40% of all HIV infections in the country. This calls for further investigation since the majority of Indian women live in a monogamous marital relationship with no risk factors of their own. Intimate partner violence against women increases their risk of acquiring HIV, diminishes their ability to protect from HIV, and thwarts their access to care. Hence, we investigated the association between HIV and IPV among currently married Indian women. We conducted a case control study in Theni district of Tamil Nadu state in South India with 256 HIV+ve women and 507 HIV-ve women. We used two type of interviews, face to face interviews (FTFI) and Audio Computer Assisted Self Interviews (ACASI) to collect both sensitive as well as non-sensitive information from each participant. Our results showed that it is common for women to experience violence in the hands of intimate partners. HIV positive women were more likely to report lifetime sexual abuse (FTFI: AOR – 2.54, 95% CI: 1.11-5.82; ACASI: AOR – 3.31, 95% CI: 1.91-5.75) than HIV negative women. We found a positive association between HIV infection and the combined experience of physical and sexual abuse compared to no abuse (FTFI: RRR – 2.44, 95% CI 1.06-5.62; ACASI: RRR – 3.03, 95% CI: 1.76-5.21). Husband’s alcohol use, husband’s controlling behaviors, previous non-partner violence and IPV among parents were associated with women’s experience of intimate partner abuse. Women who were HIV positive (ACASI: AOR – 2.02, 95% CI 1.08-3.74) and victims of previous IPV (FTFI: AOR – 9.88, 95% CI 5.37-18.18; ACASI: AOR – 7.26, 95% CI 3.70-14.21) were very likely to engage in violence against their husbands. HIV positive women with a previous history of partner abuse were also very likely to experience adverse reactions from their husbands following HIV disclosure (FTFI: AOR – 3.51, 95% CI: 1.66-7.42; ACASI: AOR – 2.74, 95% CI: 1.31-5.70). We found more number of women irrespective of their HIV status reporting positively for sensitive behaviors in ACASI than FTFI indicating that ACASI can be an efficient tool for collecting sensitive information