title: Rates and Covariates of Recent Sexual and Physical Violence Against HIV-Infected Outpatient Drinkers in Western Kenya.
abstract: Victimization from physical and sexual violence presents global health challenges. Partner violence is higher in Kenya than Africa. Violence against drinkers and HIV-infected individuals is typically elevated, so dual vulnerabilities may further augment risk. Understanding violence risks can improve interventions. Participants were 614 HIV-infected outpatient drinkers in western Kenya enrolled in a randomized trial to reduce alcohol use. At baseline, past 90-day partner physical and sexual violence were examined descriptively and in gender-stratified regression models. We hypothesized higher reported violence against women than men, and positive violence association with HIV stigma and alcohol use across gender. Women reported significantly more current sexual (26.3 vs. 5.7%) and physical (38.9 vs. 24.8%) victimization than men. Rates were generally higher than Kenyan lifetime national averages. In both regression models, HIV stigma and alcohol-related sexual expectations were significantly associated with violence while alcohol use was not. For women, higher violence risk was also conferred by childhood violence, past-year transactional sex, and younger age. HIV-infected Kenyan drinkers, particularly women, endorse high current violence due to multiple risk factors. Findings have implications for HIV interventions. Longitudinal research is needed to understand development of risk.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. rebecca_papas@brown.edu.
authors.forename: Rebecca K
authors.identifier: http://orcid.org/0000-0001-6987-4679
authors.initials: RK
authors.lastname: Papas
authors.affiliation: School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya.
authors.forename: Benson N
authors.initials: BN
authors.lastname: Gakinya
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Mwaniki
authors.affiliation: Brown University School of Public Health, Providence, RI, USA.
authors.forename: Hana
authors.initials: H
authors.lastname: Lee
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, USA.
authors.forename: Stella W
authors.initials: SW
authors.lastname: Kiarie
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Martino
authors.affiliation: Brown University School of Public Health, Providence, RI, USA.
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Loxley
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Alfred K
authors.initials: AK
authors.lastname: Keter
authors.affiliation: Edify Youth, Minneapolis, MN, USA.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Klein
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Sidle
authors.affiliation: School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya.
authors.forename: Joyce B
authors.initials: JB
authors.lastname: Baliddawa
authors.affiliation: Syracuse University, Syracuse, NY, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Maisto
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D019548:Crime Victims; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D000066550:Physical Abuse / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012307:Risk Factors; D012742:Sex Offenses / Q000706:statistics & numerical data*; D011477:Sex Work; D012725:Sexual Behavior; D012747:Sexual Partners; D057545:Social Stigma; D014754:Violence
keywords: Alcohol; HIV; Kenya; Physical violence; Sexual violence; Transactional sex