JOHANNESBURG
South African women with violent or controlling male partners run a higher risk of HIV infection, according to a study published in the Lancet medical journal.
The report, "Gender-based Violence, Relationship Power, and Risk of HIV infection in Women Attending Antenatal Clinics in South Africa", is based on a cross-sectional study of 1,366 women visiting antenatal clinics in the township of Soweto.
"Gender-based violence and gender inequality are increasingly cited as important determinants of women's HIV risk," the study noted.
Based on the interviews conducted with women in four health centres, the study postulates "that abusive men are more likely to have HIV and impose risky sexual practices on partners".
Researchers assessed associations between newly diagnosed HIV infection and experience of partner violence, male control in relationships, child sexual assault, forced first intercourse, and adult sexual assault by a non-partner among the women seeking antenatal care.
"The experience of being physically and sexually assaulted by a male intimate partner, or experiencing one of these a few times, or more, was associated with increased risk of HIV infection... An association between high levels of male control in a woman's current or most recent relationship and her HIV serostatus also persisted after adjustment for risk behaviours," researchers found.
They noted that more "research on connections between social constructions of masculinity, intimate partner violence, male dominance in relationships, and HIV risk behaviours in men, as well as effective interventions, is urgently needed".
Available evidence on sexual risk in abusive men supports these findings, the report noted. Research among working men in Cape Town, married men in India, and men in methadone maintenance programmes in New York noted that men who reported being perpetrators of partner violence were more likely to have concurrent sexual partnerships.
"Ultimately, addressing problems of gender-based violence and HIV will require broad community and societal-level transformations that challenge entrenched cultures of violence and male-dominant norms of gender relations," the study concluded.
The researchers noted that most HIV positive adults in sub-Saharan Africa were women.
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