Effect of Physical Violence on Sexually Transmitted Infections and Treatment Seeking Behaviour among Female Sex Workers in Thane District, Maharashtra, India

Background

Violence against sex workers can heighten their vulnerability to HIV and other sexually transmitted infections (STIs). Evidence suggests the risk of acquiring STI/HIV infections among female sex workers (FSWs) who have experienced violence to be almost three-times higher than FSWs, who have not experienced violence. Moreover, an experience of physical and sexual violence makes it difficult for them to negotiate safer sex with their partners and often act as a barrier to utilization of prevention services.

Methods

This study utilizes data from 2785 FSWs aged 18 years and above who participated in a cross-sectional behavioural study conducted during 2013–14 in Thane district, Maharashtra. A probability-based two-stage cluster sampling method was used for data collection. This study assesses the effect of physical violence on self-reported STI symptoms (any STI and multiple STIs) and treatment seeking for the last STI symptom using propensity score matching method.

Results

About 18% of sampled FSWs reported physical violence at the time of the survey. The likelihood of experiencing such violence was significantly higher among FSWs who solicited clients at public places, engaged in other economic activities apart from sex work, had savings, and reported high client volume per week. FSWs experiencing violence were also inconsistent condom users while engaging in sex with regular partners and clients. The average adjusted effect of violence clearly depicted an increase in the risk of any STI (11%, p<0.05) and multiple STIs (8%, p<0.10) and reduction in treatment seeking (10%, p<0.05).

Conclusions

This study demonstrates a significant effect of physical violence on reporting of any STI symptom and treatment seeking. Findings call for the immediate inclusion of strategies aimed to address violence related challenges in HIV prevention program currently being provided at Thane district. Such strategies would further help in enhancing the access to tailored STI prevention and care services among FSWs in the district.

Below:  Percentage of FSWs experienced physical Violence by type of partners, Thane, 2014

Below:  Predicted probability of experiencing physical violence; matched sample, Thane, 2014

Full article at:   http://goo.gl/BLxyW9

By:  Ravi Prakash,* Suneedh Manthri, Shaikh Tayyaba, Anna Joy, Sunil Saksena Raj, Devender Singh, and Ashok Agarwal

Alash'le G. Abimiku, Editor

HIV/AIDS Partnership for Impact through Prevention, Private Sector and Evidence-based Programming (PIPPSE) Project, Public Health Foundation of India, New Delhi, India

University of Maryland School of Medicine

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Child Brides, Forced Marriage, and Partner Violence in America: Tip of an Iceberg Revealed

Forced marriage is a violation of human rights and thwarts personal safety and well-being. Child brides are at higher risk of intimate partner violence (IPV) and often are unable to effectively negotiate safe sex, leaving them vulnerable to sexually transmitted infections, including human immunodeficiency virus, and early pregnancy. The prevalence of forced marriage and child marriage in the United States is unknown. The intersection of forced marriage and child marriage and IPV is equally unknown. 

When 277 mothers who reported IPV to shelter or justice services were asked about a forced marriage attempt, frequency and severity of IPV, mental health status, and behavioral functioning of their child, 47 (17%) reported a forced marriage attempt with 45% of the women younger than 18 years of age at the time of the attempt. Among the 47 women, 11 (23%) reported death threats, 20 (43%) reported marriage to the person, and 28 (60%) reported a pregnancy. 

Women younger than 18 years reported more threats of isolation and economic deprivation associated with the attempt as well as pressure from parents to marry. Regardless of age, women experiencing a forced marriage attempt reported more intimate partner sexual abuse, somatization, and behavior problems for their children. Forced marriage attempts occurred to one in six women (17%) reporting IPV and are associated with worse functioning for mother and child. 

The frequent occurrence and associated effect of forced marriage attempts to maternal child functioning indicates routine assessment for a forced marriage attempt as part of comprehensive care for women reporting IPV.

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By:  McFarlane J1, Nava A, Gilroy H, Maddoux J.

• 1Texas Woman's University, College of Nursing, Houston, Texas.
• Obstet Gynecol. 2016 Apr;127(4):706-713. 

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Information, Motivation, and Behavioral Skills of High-Risk Young Adults to Use the HIV Self-Test

HIV self tests (HIVST) have the potential to increase testing among young adults. However, little is known about high-risk young adults' perception of the HIVST as a risk reduction tool and how they would use the HIVST in their everyday lives. 

Our study sought to examine these factors. Twenty-one ethnically diverse participants (ages 18-24) used the HIVST at our study site, completed surveys, and underwent an in-depth interview. Descriptive statistics were used to analyze the survey responses, and interview data were coded using constructs from the information-motivation-behavioral skills model. Information deficits included: how to use the HIVST and the "window period" for sero-conversion. 

Motivations supporting HIVST use included: 

• not needing to visit the clinic, 
• fast results, 
• easy access, and 
• use in non-monogamous relationships. 

Behavioral skills discussed included: 

• coping with a positive test, 
• handling partner violence after a positive test, and 
• accessing HIV services. 

These findings can inform the use of the HIVST for improving HIV testing rates and reducing HIV risk behavior.

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By:  Brown W 3rd1,2, Carballo-Diéguez A1,3, John RM4, Schnall R5.

• 1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA.
• 2Biomedical Informatics, College of Physicians and Surgeons, Columbia University, New York, USA.
• 3Psychiatry, Mailman School of Public Health, Columbia University, New York, USA.
• 4School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA.
• 5School of Nursing, Columbia University, 617 West 168th Street, New York, NY, 10023, USA. rb897@columbia.edu. 

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Screening for Partner Violence among Family Mediation Clients: Differentiating Types of Abuse

Family mediation is mandated in Australia for couples in dispute over separation and parenting as a first step in dispute resolution, except where there is a history of intimate partner violence. However, validation of effective well-differentiated partner violence screening instruments suitable for mediation settings is at an early phase of development. 

This study contributes to calls for better violence screening instruments in the mediation context to detect a differentiated range of abusive behaviors by examining the reliability and validity of both established scales, and newly developed scales that measured intimate partner violence by partner and by self. 

The study also aimed to examine relationships between types of abuse, and between gender and types of abuse. A third aim was to examine associations between types of abuse and other relationship indicators such as acrimony and parenting alliance. The data reported here are part of a larger mixed method, naturalistic longitudinal study of clients attending nine family mediation centers in Victoria, Australia. 

The current analyses on baseline cross-sectional screening data confirmed the reliability of three subscales of the Conflict Tactics Scale (CTS2), and the reliability and validity of three new scales measuring intimidation, controlling and jealous behavior, and financial control. Most clients disclosed a history of at least one type of violence by partner: 95% reported psychological aggression, 72% controlling and jealous behavior, 50% financial control, and 35% physical assault. Higher rates of abuse perpetration were reported by partner versus by self, and gender differences were identified. There were strong associations between certain patterns of psychologically abusive behavior and both acrimony and parenting alliance. 

The implications for family mediation services and future research are discussed.

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By:   Helen Cleak1, Margot J. Schofield2, Lauren Axelsen2, Andrew Bickerdike3

1. ¹Queensland University of Technology, Brisbane, Australia
2. ²La Trobe University, Melbourne, Australia
3. ³Relationships Australia, Melbourne, Australia

1. Helen Cleak, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland 7000, Australia. Email: helen.cleak@qut.edu.au

 

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Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women

Below:  Prevalence of Childhood Physical and Sexual Abuse by Type and Perpetrators among Pregnant Women in Lima, Peru

Results
Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71).

Conclusion
These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence.

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HIV Sexual Risk and Syndemics among Women in Three Urban Areas in the United States

Via:  http://ht.ly/KarES HT @NYBloodCenter