Intimate Partner Violence and HIV Status among Ever-Married and Cohabiting Zimbabwean Women: An Examination of Partners' Traits

Predicting HIV infection in the decade (2005-2015) pre-COVID-19 in Zimbabwe: A supervised classification-based machine learning approach

The burden of HIV and related diseases have been areas of great concern pre and post the emergence of COVID-19 in Zimbabwe. Machine learning models have been used to predict the risk of diseases, including HIV accurately. Therefore, this paper aimed to determine common risk factors of HIV positivity in Zimbabwe between the decade 2005 to 2015. The data were from three two staged population five-yearly surveys conducted between 2005 and 2015. The outcome variable was HIV status. The prediction model was fit by adopting 80% of the data for learning/training and 20% for testing/prediction. Resampling was done using the stratified 5-fold cross-validation procedure repeatedly. Feature selection was done using Lasso regression, and the best combination of selected features was determined using Sequential Forward Floating Selection. We compared six algorithms in both sexes based on the F1 score, which is the harmonic mean of precision and recall. The overall HIV prevalence for the combined dataset was 22.5% and 15.3% for females and males, respectively. The best-performing algorithm to identify individuals with a higher likelihood of HIV infection was XGBoost, with a high F1 score of 91.4% for males and 90.1% for females based on the combined surveys. The results from the prediction model identified six common features associated with HIV, with total number of lifetime sexual partners and cohabitation duration being the most influential variables for females and males, respectively. In addition to other risk reduction techniques, machine learning may aid in identifying those who might require Pre-exposure prophylaxis, particularly women who experience intimate partner violence. Furthermore, compared to traditional statistical approaches, machine learning uncovered patterns in predicting HIV infection with comparatively reduced uncertainty and, therefore, crucial for effective decision-making.

Intimate partner violence and associated factors among HIV positive women attending antiretroviral therapy clinics in Gondar city, Northwest Ethiopia

INTRODUCTION

Intimate partner violence against women is a behavior within an intimate relationship that causes sexual, physical, or psychological harm to the women. It occurs among all socioeconomic, religious, and cultural groups in all settings, and affects the health of women, families, and the community at large. Determining the magnitude and determinants of intimate partner violence against HIV positive women could help to design preventive and control strategies. However, there is a dearth of information regarding the magnitude and determinants of intimate partner violence against HIV positive women in Ethiopia. Thus, this study aimed to assess the magnitude and associated factors of intimate partner violence against HIV positive women in Gondar city, Northwest Ethiopia.

METHOD

A facility-based cross-sectional study was carried out from February to May 2021 in selected public health facilities of Gondar city among 626 HIV positive women. A systematic random sampling technique was used to select study participants. Data were analyzed using Statistical Package of Social Science (SPSS) version 20 software. Bivariable and Multivariable logistic regression models were done. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify determinants of intimate partner violence. Statistical significance was considered at a p value < 0.05.

RESULTS

The overall prevalence of intimate partner violence against HIV positive women within the last 12 months was 64.2% (95% CI 60.4, 68.2). Physical violence was the most common type (54.8%), followed by sexual (51.1%) and emotional (48.9%) violence. Intimate partner violence among HIV positive women was associated with women's age 19-24 (AOR = 0.13, 95% CI 0.02, 0.79), monthly income of 500-2500 (AOR = 6.5, 95% CI 1.72, 25.0), urban residence (AOR = 0.35, 95% CI 0.13, 0.91), partner drink alcohol (AOR = 2.14, 95% CI 1.42, 4.06), and a husband with no multiple sexual partners (AOR = 0.75, 95% CI 0.34, 0.94).

CONCLUSION

The result of this study revealed that intimate partner violence against HIV positive women was found to be high. Thus, protective measures that could increase the community's and women's awareness about the consequences of various forms of violence, and women empowerment are paramount. Priorities in programs of gender-based violence prevention should involve women from rural residences, older age, and males who consume alcohol.

Socio-demographic predictors of gender inequality among heterosexual couples expecting a child in south-central Uganda

BACKGROUND

Gender inequality is a pervasive problem in sub-Saharan Africa, and has negative effects on health and development.

OBJECTIVE

Here, we sought to identify socioeconomic predictors of gender inequality (measured by low decision-making power and high acceptance of intimate partner violence) within heterosexual couples expecting a child in south-central Uganda.

METHOD

We used data from a two-arm cluster randomized controlled HIV self-testing intervention trial conducted in three antenatal clinics in south-central Uganda among 1,618 enrolled women and 1,198 male partners. Analysis included Cochran Mantel-Haenzel, proportional odds models, logistic regression, and generalized linear mixed model framework to account for site-level clustering.

RESULTS

Overall, we found that 31.1% of men had high acceptance of IPV, and 15.9% of women had low decision-making power. We found religion, education, HIV status, age, and marital status to significantly predict gender equality. Specifically, we observed lower gender equality among Catholics, those with lower education, those who were married, HIV positive women, and older women.

CONCLUSION

By better understanding the prevalence and predictors of gender inequality, this knowledge will allow us to better target interventions (increasing education, reducing HIV prevalence in women, targeting interventions different religions and married couples) to decrease inequalities and improve health care delivery to underserved populations in Uganda.

Sexual Violence in Women with HIV Positive Spouse and Their Mental Health

Background: Sexual violence (SV) against women is one of the most important issues in women's health. We aimed to investigate the related variable for SV against women with HIV spouse and its relationship with mental problems in them.

Study design: A cross-sectional study.

Methods: This study was performed on 143 women referred to Hamadan and Malayer Risky Behavior Related Disease Clinic (Triangular Clinic), located in Comprehensive Health Service centers, Iran in 2019. SV and mental problems were assessed using standard questionnaires, based on interview. All analyses performed using SPSS. The significance level of all analyses was considered 0.05.

Results: Totally, 407 HIV+ patients were diagnosed from 1998 to 2018, in Hamadan and Malayer cities. We assessed the wives of survivors who allowed about SV. Mean of SV in women with HIV positive spouse was significantly higher than control group (P=0.004). Among all variables, unsafe sex, extramarital relationship, smoking, alcohol, multi-partner and suicide were significantly related to SV; but age, living area, educational status, income and job in both men and women had not statically significant relationship with SV.

Conclusion: SV besides its complications and mental problems in women with HIV positive spouses must be considered in interventional programs in order to improve sexual rights in this vulnerable group in the future.

Victims and Perpetrators of Intimate Partner Violence Among Sexually Active Youth in a Community With a High HIV Prevalence in Western Kenya

BACKGROUND

Physical intimate partner violence (IPV) is an important risk factor for sexually transmitted infections, including HIV. We set out to determine the prevalence and correlates of IPV among youth aged 15 to 24 years - in a community with a high HIV prevalence - with a view to recommending strategies to address IPV.

METHODS

We analysed data from an HIV seroprevalence survey, which included participants aged 13 years and above and was conducted between November 2012 and December 2014 in Gem Subcounty, Siaya County, Western Kenya. Participants between 15 and 24 years old (youth) were described as "perpetrators of IPV" if they had done anything to physically hurt their sexual partners in the previous year and as "victims of IPV" if they had been physically hurt by a sexual partner in the same timeframe. Logistic regression was used to determine factors associated with being either a victim or perpetrator of IPV.

RESULTS

Of 1,957 participants included in the analysis, 142 (7%) were victims of IPV, and 77 (4%) were perpetrators of IPV. Victims were likely to be women (adjusted odds ratio [AOR] 7.9; 95% CI, 3.6 to 17.5), in a relationship or married (AOR 3.1; 95% CI, 1.8 to 5.4), and to have had multiple lifetime sexual partners. Victims of IPV were also more likely than not to have been subjected to sexual violence in the past (AOR 1.9; 95% CI, 1.0 to 3.4) or recently (AOR 3.9; 95% CI, 2.2 to 6.8). Perpetrators were likely to be men (AOR 2.1; 95% CI, 1.2 to 3.7), with 5 or more lifetime sexual partners (AOR 2.8; 95% CI, 1.3 to 6.3), and to have committed sexual violence recently (AOR 2.9; 95% CI, 1.1 to 7.7).

CONCLUSION

There was a high prevalence of IPV among sexually active youth in this rural community. Study participants were recurrent victims or perpetrators and reported behaviours that put them at risk of HIV acquisition. Health programmes should screen for IPV victims and perpetrators using identified characteristics. Existing policies regarding gender-based violence should be enforced, and future research should focus on the impact of IPV prevention programmes.