A Prospective Cohort Study of Intimate Partner Violence and Unprotected Sex in HIV-Positive Female Sex Workers in Mombasa, Kenya.
We conducted a prospective cohort study to test the hypothesis that intimate partner violence (IPV) is associated with unprotected sex in HIV-positive female sex workers in Mombasa, Kenya. Women completed monthly visits and quarterly examinations. Any IPV in the past year was defined as ≥1 act of physical, sexual, or emotional violence by the current or most recent emotional partner ('index partner'). Unprotected sex with any partner was measured by self-report and prostate specific antigen (PSA) test. Recent IPV was associated with significantly higher risk of unprotected sex (adjusted relative risk [aRR] 1.91, 95 % CI 1.32, 2.78, p = 0.001) and PSA (aRR 1.54, 95 % CI 1.17, 2.04, p = 0.002) after adjusting for age, alcohol use, and sexual violence by someone besides the index partner. Addressing IPV in comprehensive HIV programs for HIV-positive women in this key population is important to improve wellbeing and reduce risk of sexual transmission of HIV.
Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA. ksw@uw.edu.|Department of Epidemiology, University of Washington, Seattle, USA. ksw@uw.edu.
Kate S
KS
Wilson
Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA.
Ruth
R
Deya
Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA.
Krista
K
Yuhas
Department of Psychology, University of Washington, Seattle, USA.
Jane
J
Simoni
Department of Epidemiology, University of Washington, Seattle, USA.
Ann
A
Vander Stoep
University of Nairobi, Nairobi, Kenya.|Coast Province General Hospital, Mombasa, Kenya.
Juma
J
Shafi
University of Nairobi, Nairobi, Kenya.
Walter
W
Jaoko
Department of Biostatistics, University of Washington, Seattle, USA.
James P
JP
Hughes
Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA.|Department of Biostatistics, University of Washington, Seattle, USA.
Barbra A
BA
Richardson
Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA.|Department of Epidemiology, University of Washington, Seattle, USA.|Department of Medicine, University of Washington, Seattle, USA.|University of Nairobi, Nairobi, Kenya.
R Scott
RS
McClelland
D000328:Adult; D000428:Alcohol Drinking; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D000066511:Intimate Partner Violence / Q000706:statistics & numerical data; D007630:Kenya / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data; D060386:Sex Workers / Q000523:psychology*; D012725:Sexual Behavior; D012747:Sexual Partners / Q000523:psychology; D047568:Unsafe Sex / Q000706:statistics & numerical data*
Africa; Female sex workers; Intimate partner violence; Prospective study; Unprotected sex