All ETDs from UAB

Advisory Committee Chair

John E Ehiri

Advisory Committee Members

Herman Foushee

Pauline E Jolly

Russell S Kirby

Fred Wabwire-Mangen

Document Type

Dissertation

Date of Award

2007

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

We sought to estimate the prevalence of sexual violence and sexually transmitted diseases (STDs), identify risk factors for sexual violence and STDs among women in Human Immunodeficiency Virus (HIV) discordant unions, and investigate the lived experiences of sexual violence among women in HIV discordant unions attending post-test club services at AIDS Information Centers (AICs) in Uganda. We carried out a prospective cohort study of women in HIV discordant and HIV negative concordant unions after disclosure of their HIV serostatus. We estimated prevalence of STDs in the two study cohorts and compared them for occurrence of risk factors for sexual violence and STDs. We then investigated the lived experiences of sexual violence by selected women in HIV discordant unions attending AIC post-test club services in Uganda. Prevalence of sexual violence among women in HIV discordant unions was similar to that among women in HIV negative concordant unions. Risk factors for sexual violence among women in HIV discordant union were: low education level, transactional sex, prior experience of sexual violence, history of STDs, having other sexual partners, history of alcohol use. Prevalence of STDs was higher among women in HIV discordant unions ccompared to those in HIV negative concordant unions. ii None of the risk factors for STDs mentioned in literature were associated with STDs among women in HIV discordant unions. There was no association between STDs among women in HIV discordant unions and reported experience of sexual violence. Use of physical force and verbal threats were the most common forms of sexual violence, which evoked diverse reactions and feelings, including concern about premature death, fear of infection, desire to separate, helplessness, anger and suicidal tendencies. Alcohol abuse by the male partners was a major factor exacerbating sexual violence.

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