High rates of lifetime and recent violence observed among harder-to-reach women living with HIV

Abstract

This study examined the prevalence and correlates associated with lifetime and recent violence among a sample of harder-to-reach human immunodeficiency virus (HIV)-positive women living in British Columbia (BC), Canada. Interviewer-led surveys with 1000 participants gathered quantitative data on social, economic, and structural characteristics such as housing status, relationship status, family structure, history of drug use, and sexual behavior. Logistic regression analysis modeled associations between independent variables and experiences of violence at baseline. Cox regression analyses with time-dependent covariates determined correlates of lifetime and recent violence among HIV-positive women. Of the 249 women in the study, an overwhelming proportion of women (81%) reported experiences of violence in their lifetime. Among those, 22% reported recent experiences of violence, and 56% of the women reported more than five violent episodes in their lifetime. Lifetime violence was independently associated with HIV-related stigma (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [CI] = 1.14–5.70), previous tobacco use (AOR = 2.79, 95% CI = 1.10–7.07), ever having a drinking problem (AOR = 2.82, 95% CI = 1.28–6.23), and ever having received care for a mental health condition (AOR = 2.42, 95% CI = 1.06–5.52). Recent violence was associated with the current illicit drug use (AOR = 2.60, 95% CI = 1.14–5.90), and currently residing in unstable housing (AOR = 2.75, 95% CI = 1.31–5.78). This study underscores the need to consider potential experiences of historical and current violence as part of comprehensive care for women living with HIV.