title: Relationship Power and Sexual Violence Among HIV-Positive Women in Rural Uganda.
abstract: Gender-based power imbalances place women at significant risk for sexual violence, however, little research has examined this association among women living with HIV/AIDS. We performed a cross-sectional analysis of relationship power and sexual violence among HIV-positive women on anti-retroviral therapy in rural Uganda. Relationship power was measured using the Sexual Relationship Power Scale (SRPS), a validated measure consisting of two subscales: relationship control (RC) and decision-making dominance. We used multivariable logistic regression to test for associations between the SRPS and two dependent variables: recent forced sex and transactional sex. Higher relationship power (full SRPS) was associated with reduced odds of forced sex (AOR = 0.24; 95 % CI 0.07-0.80; p = 0.020). The association between higher relationship power and transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18-1.22; p = 0.119). Higher RC was associated with reduced odds of both forced sex (AOR = 0.18; 95 % CI 0.06-0.59; p < 0.01) and transactional sex (AOR = 0.38; 95 % CI 0.15-0.99; p = 0.048). Violence prevention interventions with HIV-positive women should consider approaches that increase women's power in their relationships.
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California - San Francisco, 550 16th Street 3rd Floor, San Francisco, CA, USA. amy.conroy@ucsf.edu.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Conroy
authors.affiliation: Center for Global Health, Massachusetts General Hospital, Boston, USA.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Tsai
authors.affiliation: Department of Psychiatry, Kaiser Permanente, San Franscisco, USA.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Clark
authors.affiliation: Faculty of Medicine, Mbarara University of Science & Technology, Mbarara, Uganda.
authors.forename: Yap
authors.initials: Y
authors.lastname: Boum
authors.affiliation: Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|Division of HIV/AIDS, Department of Medicine, University of California - San Francisco, San Francisco, USA.
authors.forename: Abigail M
authors.initials: AM
authors.lastname: Hatcher
authors.affiliation: Faculty of Medicine, Mbarara University of Science & Technology, Mbarara, Uganda.
authors.forename: Annet
authors.initials: A
authors.lastname: Kawuma
authors.affiliation: Division of HIV/AIDS, Department of Medicine, University of California - San Francisco, San Francisco, USA.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hunt
authors.affiliation: Department of Epidemiology, University of California - San Francisco, San Francisco, USA.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Martin
authors.affiliation: Center for Global Health, Massachusetts General Hospital, Boston, USA.|Department of Medicine, Harvard University, Boston, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.affiliation: Division of HIV/AIDS, Department of Medicine, University of California - San Francisco, San Francisco, USA.
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D011209:Power, Psychological; D012307:Risk Factors; D012424:Rural Population; D012742:Sex Offenses / Q000208:ethnology / Q000523:psychology*; D012725:Sexual Behavior; D057545:Social Stigma; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: Africa; HIV/AIDS; Relationship power; Sexual violence; Transactional sex