A prospective study of exposure to gender-based violence and risk of sexually transmitted infection acquisition in the women's interagency hiv study, 1995-2018

Ruth J. Geller, Michele R. Decker, Adebola A. Adedimeji, Kathleen M. Weber, Seble Kassaye, Tonya N. Taylor, Jennifer Cohen, Adaora A. Adimora, Lisa B. Haddad, Margaret Fischl, Sarah Cunningham, Elizabeth T. Golub

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Our objectives were to estimate the association of gender-based violence (GBV) experience with the risk of sexually transmitted infection (STI) acquisition in HIV-seropositive and HIV-seronegative women, to compare the STI risks associated with recent and lifetime GBV exposures, and to quantify whether these associations differ by HIV status. Methods: We conducted a multicenter, prospective cohort study in the Women's Interagency HIV Study, 1994- 2018. Poisson models were fitted using generalized estimating equations to estimate the association of past 6-month GBV experience (physical, sexual, or intimate partner psychological violence) with subsequent self-reported STI diagnosis (gonorrhea, syphilis, chlamydia, pelvic inflammatory disease, or trichomoniasis). Results: Data from 2868 women who reported recent sexual activity comprised 12,069 person-years. Higher STI risk was observed among HIV-seropositive women (incidence rate [IR] 5.5 per 100 person-years) compared with HIV-seronegative women (IR 4.3 per 100 person-years). Recent GBV experience was associated with a 1.28-fold (95% confidence interval [CI] 0.99, 1.65) risk after adjustment for HIV status and relevant demographic, socioeconomic, and sexual risk variables. Other important risk factors for STI acquisition included unstable housing (adjusted incidence rate ratio [AIRR] 1.81, 95% CI 1.32-2.46), unemployment (AIRR 1.42, 95% CI 1.14-1.76), transactional sex (AIRR 2.06, 95% CI 1.52-2.80), and drug use (AIRR 1.44, 95% CI 1.19- 1.75). Recent physical violence contributed the highest risk of STI acquisition among HIV-seronegative women (AIRR 2.27, 95% CI 1.18-4.35), whereas lifetime GBV experience contributed the highest risk among HIVseropositive women (AIRR 1.59, 95% CI 1.20-2.10). Conclusions: GBVprevention remains an important public health goalwith direct relevance towomen's sexual health.

Original languageEnglish (US)
Pages (from-to)1256-1267
Number of pages12
JournalJournal of Women's Health
Volume29
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • HIV
  • Intimate partner violence
  • Physical violence
  • Sexual violence
  • Sexually transmitted infections

ASJC Scopus subject areas

  • Medicine(all)

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