Relationship Power and Sexual Violence Among HIV-Positive Women in Rural Uganda

• Published in: AIDS and behavior Vol. 20; no. 9; pp. 2045 - 2053
• Main Authors: Conroy, Amy A., Tsai, Alexander C., Clark, Gina M., Boum, Yap, Hatcher, Abigail M., Kawuma, Annet, Hunt, Peter W., Martin, Jeffrey N., Bangsberg, David R., Weiser, Sheri D.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2016; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Adult; Aggression; AIDS; Anti-Retroviral Agents - therapeutic use; Cross-Sectional Studies; Decision making; Dependent variables; Domestic violence; Female; Females; Gender; Health Psychology; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - ethnology; HIV Infections - psychology; HIV Seropositivity - psychology; Human immunodeficiency virus; Humans; Infectious Diseases; Lentivirus; Logistic Models; Male; Medicine; Medicine & Public Health; Multivariable control; Original Paper; Personal relationships; Power; Power (Psychology); Prevention; Public Health; Regression analysis; Risk Factors; Rural areas; Rural Population; Sex; Sex crimes; Sex Offenses - ethnology; Sex Offenses - psychology; Sexual assault; Sexual Behavior; Sexually transmitted diseases; Social Stigma; Statistical analysis; STD; Uganda - epidemiology; Violence; Women; Young Adult; Uganda; Transactional sex; HIV/AIDS; Relationship power; Sexual violence; Africa
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-016-1385-y

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.