Partner Violence Tied to HIV for African Women

In a study of women attending a health clinic in Dar es Salaam, Tanzania, investigators found that among those who had not told their partners their HIV status, fear of violence or abandonment was the major reason. Suzanne Maman of Johns Hopkins University and colleagues followed 245 women who sought HIV testing and counseling in 1999. They interviewed the women three months after they had been tested. The interviews garnered some encouraging signs -- namely, that many more women in this study told their partners their HIV test results, compared with a similar group of women surveyed a few years earlier. However, HIV-positive women were less likely to reveal their status than were women who tested negative. And the top reason was "fear of the partner's reaction," Maman's team reports.

Among HIV-positive women, 64 percent had shared their test results with their partners, while 83 percent of HIV-negative women had done so. Among all women, regardless of HIV status, 52 percent feared their partner's reaction. In an earlier phase of the study that included men, both men and women often said women should "seek permission" from their partners to get HIV tests. Overall, nearly 39 percent of the women said they had been physically abused by at least one partner, and about 17 percent had been sexually abused. HIV-positive women were nearly three times more likely than HIV-negative women to report abuse from their current partner.

Maman's team suggested that HIV counselors be trained in how to ask questions about partner violence and be able to refer abused women to social services. And, they concluded, broader cultural awareness of the problem is needed. "The strong association between prior history of violence and HIV infection does support the theory that violence plays a role in women's risk for HIV infection in this population," the researchers wrote. The report appears in Population Briefs (2001;7;2).

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