Mitigating intimate partner violence among South African women testing HIV positive during mobile counseling and testing

AIDS Care. 2018 Jan;30(1):65-71. doi: 10.1080/09540121.2017.1366414. Epub 2017 Sep 13.

Abstract

South African women continue to suffer disproportionately from the interlinked epidemics of HIV and intimate partner violence (IPV). Effective strategies are needed to mitigate HIV-related IPV, which often creates barriers to successful engagement along the HIV continuum of care. More information is needed on how IPV impacts women's safety following mobile HCT diagnosis, and the HIV IPV Risk Assessment & Safety-planning (HIRS) protocol was developed to address several related gaps in knowledge. The sample included 255 black South African women experiencing IPV and testing HIV+ during mobile HCT in Gauteng province. Outcomes were compared between a standard of care (SOC) group and an Experimental group with two dosage levels (D1, D2). Of the total sample and in the last year, 99.2% had experienced non-violent control, 40.7% physical abuse, 44.8% sexual abuse, and 67.3% physical or sexual abuse. There were no significant differences in pre/post safety scores, or for satisfaction or acceptability items. The overall linkage rate was 45.8% (M = 12.97 days), and the Experimental group had more links to care in certain age groups-the highest in those aged ≤23 years in D1 (70%). The lowest linkage rate was for those aged 33-43 years in the SOC (22.2%). Almost two thirds of participants reported using the safety plan (61.9%), with 80% reporting it was helpful, and 80% using ≥1 safety strategy. The Experimental group reported significantly less violence upon partner notification of serostatus, but all groups felt significantly less safe getting to medical appointments by post-test. Overall, the study indicates the HIRS protocol is safe and helpful, brief to administer, and may mitigate violence during partner notification of serostatus, but further investigation is needed before implementing it as a standard of care.

Keywords: Intimate partner violence; South Africa; mobile HCT; partner notification.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Black People / ethnology
  • Black People / psychology*
  • Counseling
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • Humans
  • Intimate Partner Violence / ethnology
  • Intimate Partner Violence / psychology*
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • South Africa / epidemiology
  • Spouse Abuse / psychology
  • Young Adult