Domestic Violence More Likely to Start After HIV Diagnosis for Pregnant Women

Partner violence negatively impacts the ability of women with HIV to adhere to antiretrovirals.

Domestic violence is twice as likely to begin postpartum if a woman receives an HIV-positive diagnosis during pregnancy, new research finds.

For the study, published in AIDS and Behavior, investigators used data from an urban township in the KwaZuluNatal Province of South Africa—–an area with the highest HIV prevalence in the country.

Initially, the investigators hypothesized that women diagnosed with HIV during pregnancy and who previously experienced violence in their relationship would be more likely to experience an increase in violence.

Data were gathered from 1015 women in steady relationships—–defined as 6 months or more­––at the time of collection.

The results of the study showed that women who did not have prior violence in their relationship were twice as likely to experience domestic violence after receiving an HIV diagnosis during pregnancy.

“It is valuable to have a picture of who is at risk because intimate partner violence negatively affects HIV positive women’s ability to adhere to their medications and to engage in care, both of which can negatively affect their health and wellbeing, as well as the wellbeing of their infants,” said author Ali Groves, PhD. “Better knowing who’s at risk means we can implement prevention interventions in the antenatal and postnatal clinic setting to positively impact their health.”

No significant changes were observed after an HIV diagnosis in pregnancy among women who already experienced violence in their relationships. The authors noted that although the levels of violence did not increase, they did not decrease either.

“This suggests that something about the HIV-positive diagnosis is bringing stress into the relationship for those without a history of intimate partner violence,” Groves said. “On the other hand, in those with a history of intimate partner violence, there was no difference in risk between HIV-positive and HIV-negative women. This suggests that the HIV-positive diagnosis may not be [a] new source of anger or increased relationship stress, as it may have already been suspected.”

Based on the findings, the authors believe that domestic violence intervention efforts need to be ramped up to target women who have not already experienced violence in their relationships.

“We believe this research will translate beyond South Africa because relationship factors that contribute to HIV-positive women’s vulnerability to intimate partner violence are not unique to just that country,” Groves added.

Interventions are also important for women who already have a history of domestic violence in their relationship, since the findings indicated that the violence levels remained, according to the authors.

“As we found, women with a history of intimate partner violence continue to experience it postpartum,” Groves said. “Intimate partner violence has significant negative consequences for both women and their children during the period before and after pregnancy, and these consequences are not limited to HIV-positive women. As such, effective interventions to reduce women’s risk of violence are desperately needed.”