Intimate Partner Violence and Determinants of HIV Seroconversion among Female Caregivers in Kwazulu-Natal, South Africa: Insights from the Asenze Longitudinal Study.

Abstract

Intimate partner violence (IPV) has been associated with HIV seroconversion vulnerability, but few studies have examined multiple IPV types and HIV status. This study investigates exposure to various IPV types and HIV seroconversion among female caregivers in KwaZulu-Natal (KZN), South Africa, using longitudinal data (2008-2021) from the Asenze cohort study. We compared IPV exposure at baseline (Wave 1[W1]), sociodemographic, and psychosocial characteristics between women living with HIV (WLHIV) vs. HIV-negative at baseline; HIV-negative at baseline who seroconverted by Wave 3 (W3) vs. remaining HIV-negative, using chi-squared and t-tests. We also assessed seroconversion over time in the cohort. At W1, of 580 participants (WLHIV = 139, HIV-negative = 431), 42% reported any IPV. Considering both current and other partners, WLHIV reported higher exposure to threatening IPV (34% vs. 23%, p = .005) and multiple IPV types (32% vs. 23%, p = .029). From an other partner, WLHIV reported more physical IPV (32% vs. 21%, p = .010), any IPV (35% vs. 26%, p = .049), and multiple IPV types (23% vs. 15%, p = .029). No significant differences in IPV from a current partner were found between WLHIV and HIV-negative women. Those who seroconverted by W3 vs. remained HIV-negative at W3 did not differ on any IPV exposures. Women who seroconverted were younger (28.2 vs. 37.8, p <.001) and more likely to report hazardous drinking at W1 (13% vs. 3%, p <.001). The high levels of HIV seroconversion and IPV indicate a persistent HIV and IPV epidemic among female caregivers in KZN, necessitating expanded research and interventions.