title: Diagnosis and Disclosure of HIV Status: Implications for Women's Risk of Physical Partner Violence in the Postpartum Period.
abstract: BACKGROUND
  This study prospectively examined whether HIV leads to elevated risk for intimate partner violence (IPV) for women and how this risk varies depending on HIV status disclosure to a partner.
  
  
  METHODS
  We ran a series of logistic regression models using data from 1092 pregnant and postpartum women enrolled in an RCT in Durban, South Africa. Model 1 assessed whether baseline HIV status predicted 14-week postpartum physical IPV, controlling for baseline physical IPV, disclosure to partner, and demographic and study covariates. Model 2 added the interaction between HIV status and disclosure.
  
  
  RESULTS
  HIV was not associated with 14-week physical IPV in the main effects model [adjusted odds ratio: 1.34, 95% confidence interval (CI): 0.88 to 2.05]. However, there was a statistically significant positive interaction between HIV and disclosure (adjusted odds ratio: 0.22, 95% CI: 0.05 to 0.96). Among women who disclosed their HIV status, HIV was not significantly associated with 14-week IPV (adjusted odds ratio: 1.12, 95% CI: 0.71 to 1.89). However, among women who had not disclosed, the odds of reporting IPV at 14 weeks was 5.15 times higher for HIV-positive women as compared with HIV-negative women (95% CI: 1.25 to 21.00).
  
  
  CONCLUSIONS
  Although we established that HIV does not increase incidence of IPV for all HIV-positive women, we found an elevated risk of IPV among the HIV-positive women who chose not to disclose their status to their partner. Nondisclosure is likely a marker for other problematic aspects of the relationship, and counselors should either find alternative safe options for disclosure or support women's decisions not to disclose.
authors.affiliation: *Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; †Center on Health, Risk and Society, American University, Washington, DC; and ‡Department of Obstetrics and Gynaecology, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Maman
authors.forename: Allison K
authors.initials: AK
authors.lastname: Groves
authors.forename: H Luz
authors.initials: HL
authors.lastname: McNaughton Reyes
authors.forename: Dhayendre
authors.initials: D
authors.lastname: Moodley
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D000066511:Intimate Partner Violence / Q000523:psychology* / Q000706:statistics & numerical data; D016015:Logistic Models; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners / Q000523:psychology*; D013019:South Africa / Q000453:epidemiology; D014342:Truth Disclosure