Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission

نویسندگان

  • Abigail M Hatcher
  • Nataly Woollett
  • Christina C Pallitto
  • Keneuoe Mokoatle
  • Heidi Stöckl
  • Catherine MacPhail
  • Sinead Delany-Moretlwe
  • Claudia García-Moreno
چکیده

INTRODUCTION Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. METHODS We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team-based approach to thematic coding. FINDINGS We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis during pregnancy, and subsequent partner disclosure, were noted as a common trigger of IPV. Disclosure leads to violence because it causes relationship conflict, usually related to perceived infidelity and the notion that women are "bringing" the disease into the relationship. IPV worsened HIV-related health through poor PMTCT adherence, since taking medication or accessing health services might unintentionally alert male partners of the women's HIV status. IPV also impacted on HIV-related health via mental health, as women described feeling depressed and anxious due to the violence. IPV led to secondary HIV risk as women experienced forced sex, often with little power to negotiate condom use. Pregnant women described staying silent about condom negotiation in order to stay physically safe during pregnancy. CONCLUSIONS IPV is a crucial issue in the lives of pregnant women and has bidirectional links with HIV-related health. IPV may worsen access to PMTCT and secondary prevention behaviours, thereby posing a risk of secondary transmission. IPV should be urgently addressed in antenatal care settings to improve uptake of PMTCT and ensure that goals of maternal and child health are met in sub-Saharan African settings.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Intimate partner violence against women in eastern Uganda: implications for HIV prevention

BACKGROUND We were interested in finding out if the very low antenatal VCT acceptance rate reported in Mbale Hospital was linked to intimate partner violence against women. We therefore set out to i) determine the prevalence of intimate partner violence, ii) identify risk factors for intimate partner violence and iii) look for association between intimate partner violence and HIV prevention par...

متن کامل

Prevention of Mother to Child HIV Transmission

In Iran 8% of HIV- infected cases are women. Since most of them are young and in childbearing ages, in case of becoming pregnant and not receiving preventive measures, they can infect their child. Without Preventive measures transmission rate is 15 to 45 percent. Several factors such as sever stage of HIV and AIDS ,CD4 low count, high viral loud, acute retroviral phase, STDs, vaginal delivery, ...

متن کامل

Pnm-7: Intimate Partner Violence and Antenatal Depression among Pregnant Women in Iran

Background: Domestic violence against women is a significant public health issue in both developed and developing countries of the world. Intimate partner violence during pregnancy can result in adverse outcomes for both mothers and their infants. Partner violence against women is common during pregnancy and might have an adverse effect on the mental health of women during antenatal pregnancy. ...

متن کامل

Male Partner Participation in Preventing Mother-to-Child Transmission of Human-Immunodeficiency Virus (PMCHT) and its Predictive Factors in Bishoftu, Central Ethiopia

Background & aim: Globally, human-immunodeficiency virus (HIV) is threating the lives of human being. Despite the several programs supporting male partner involvement in the prevention of mother-to-child HIV transmission (PMCHT), only few male partners have accepted and involved in this process. Regarding this, the present study aimed to assess male partner involvement in the PMCHT and its asso...

متن کامل

Home visits during pregnancy enhance male partner HIV counselling and testing in Kenya: a randomized clinical trial.

BACKGROUND HIV testing male partners of pregnant women may decrease HIV transmission to women and promote uptake of prevention of mother-to-child HIV transmission (PMTCT) interventions. However, it has been difficult to access male partners in antenatal care (ANC) clinics. We hypothesized that home visits to offer HIV testing to partners of women attending ANC would increase partner HIV testing...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 17  شماره 

صفحات  -

تاریخ انتشار 2014