Physical and Sexual Violence Predictors: 20 Years of the Women's Interagency HIV Study Cohort

Michele R. Decker; Lorie Benning; Kathleen M. Weber; Susan G. Sherman; Adebola Adedimeji; Tracey E. Wilson; Jennifer Cohen; Michael W. Plankey; Mardge H. Cohen; Elizabeth T. Golub

doi:10.1016/j.amepre.2016.07.005

Physical and Sexual Violence Predictors: 20 Years of the Women's Interagency HIV Study Cohort

Michele R. Decker
, Lorie Benning
, Kathleen M. Weber
, Susan G. Sherman
, Adebola Adedimeji
, Tracey E. Wilson
, Jennifer Cohen
, Michael W. Plankey
, Mardge H. Cohen
, Elizabeth T. Golub

School of Public Health

SUNY Downstate Health Sciences University

Research output: Contribution to journal › Article › peer-review

44 Scopus citations

Abstract

Introduction Gender-based violence (GBV) threatens women's health and safety. Few prospective studies examine physical and sexual violence predictors. Baseline/index GBV history and polyvictimization (intimate partner violence, non-partner sexual assault, and childhood sexual abuse) were characterized. Predictors of physical and sexual violence were evaluated over follow-up. Methods HIV-infected and uninfected participants (n=2,838) in the Women's Interagency HIV Study provided GBV history; 2,669 participants contributed 26,363 person years of follow-up from 1994 to 2014. In 2015–2016, multivariate log-binomial/Poisson regression models examined violence predictors, including GBV history, substance use, HIV status, and transactional sex. Results Overall, 61% reported index GBV history; over follow-up, 10% reported sexual and 21% reported physical violence. Having experienced all three forms of past GBV posed the greatest risk (adjusted incidence rate ratio [AIRR]_physical=2.23, 95% CI=1.57, 3.19; AIRR_sexual=3.17, 95% CI=1.89, 5.31). Time-varying risk factors included recent transactional sex (AIRR_physical=1.29, 95% CI=1.03, 1.61; AIRR_sexual=2.98, 95% CI=2.12, 4.19), low income (AIRR_physical=1.22, 95% CI=1.01, 1.45; AIRR_sexual=1.38, 95% CI=1.03, 1.85), and marijuana use (AIRR_physical=1.43, 95% CI=1.22, 1.68; AIRR_sexual=1.57, 95% CI=1.19, 2.08). For physical violence, time-varying risk factors additionally included housing instability (AIRR=1.37, 95% CI=1.15, 1.62); unemployment (AIRR=1.38, 95% CI=1.14, 1.67); exceeding seven drinks/week (AIRR=1.44, 95% CI=1.21, 1.71); and use of crack, cocaine, or heroin (AIRR=1.76, 95% CI=1.46, 2.11). Conclusions Urban women living with HIV and their uninfected counterparts face sustained GBV risk. Past experiences of violence create sustained risk. Trauma-informed care, and addressing polyvictimization, structural inequality, transactional sex, and substance use treatment, can improve women's safety.

Original language	English
Pages (from-to)	731-742
Number of pages	12
Journal	American Journal of Preventive Medicine
Volume	51
Issue number	5
DOIs	https://doi.org/10.1016/j.amepre.2016.07.005
State	Published - Nov 1 2016

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@article{d6efb834877c42e0b5c668fe040b0b58,

title = "Physical and Sexual Violence Predictors: 20 Years of the Women's Interagency HIV Study Cohort",

abstract = "Introduction Gender-based violence (GBV) threatens women's health and safety. Few prospective studies examine physical and sexual violence predictors. Baseline/index GBV history and polyvictimization (intimate partner violence, non-partner sexual assault, and childhood sexual abuse) were characterized. Predictors of physical and sexual violence were evaluated over follow-up. Methods HIV-infected and uninfected participants (n=2,838) in the Women's Interagency HIV Study provided GBV history; 2,669 participants contributed 26,363 person years of follow-up from 1994 to 2014. In 2015–2016, multivariate log-binomial/Poisson regression models examined violence predictors, including GBV history, substance use, HIV status, and transactional sex. Results Overall, 61\% reported index GBV history; over follow-up, 10\% reported sexual and 21\% reported physical violence. Having experienced all three forms of past GBV posed the greatest risk (adjusted incidence rate ratio [AIRR]physical=2.23, 95\% CI=1.57, 3.19; AIRRsexual=3.17, 95\% CI=1.89, 5.31). Time-varying risk factors included recent transactional sex (AIRRphysical=1.29, 95\% CI=1.03, 1.61; AIRRsexual=2.98, 95\% CI=2.12, 4.19), low income (AIRRphysical=1.22, 95\% CI=1.01, 1.45; AIRRsexual=1.38, 95\% CI=1.03, 1.85), and marijuana use (AIRRphysical=1.43, 95\% CI=1.22, 1.68; AIRRsexual=1.57, 95\% CI=1.19, 2.08). For physical violence, time-varying risk factors additionally included housing instability (AIRR=1.37, 95\% CI=1.15, 1.62); unemployment (AIRR=1.38, 95\% CI=1.14, 1.67); exceeding seven drinks/week (AIRR=1.44, 95\% CI=1.21, 1.71); and use of crack, cocaine, or heroin (AIRR=1.76, 95\% CI=1.46, 2.11). Conclusions Urban women living with HIV and their uninfected counterparts face sustained GBV risk. Past experiences of violence create sustained risk. Trauma-informed care, and addressing polyvictimization, structural inequality, transactional sex, and substance use treatment, can improve women's safety.",

author = "Decker, \{Michele R.\} and Lorie Benning and Weber, \{Kathleen M.\} and Sherman, \{Susan G.\} and Adebola Adedimeji and Wilson, \{Tracey E.\} and Jennifer Cohen and Plankey, \{Michael W.\} and Cohen, \{Mardge H.\} and Golub, \{Elizabeth T.\}",

note = "Publisher Copyright: {\textcopyright} 2016 American Journal of Preventive Medicine",

year = "2016",

month = nov,

day = "1",

doi = "10.1016/j.amepre.2016.07.005",

language = "English",

volume = "51",

pages = "731--742",

journal = "American Journal of Preventive Medicine",

issn = "0749-3797",

publisher = "Elsevier Inc.",

number = "5",

}

TY - JOUR

T1 - Physical and Sexual Violence Predictors

T2 - 20 Years of the Women's Interagency HIV Study Cohort

AU - Decker, Michele R.

AU - Benning, Lorie

AU - Weber, Kathleen M.

AU - Sherman, Susan G.

AU - Adedimeji, Adebola

AU - Wilson, Tracey E.

AU - Cohen, Jennifer

AU - Plankey, Michael W.

AU - Cohen, Mardge H.

AU - Golub, Elizabeth T.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Introduction Gender-based violence (GBV) threatens women's health and safety. Few prospective studies examine physical and sexual violence predictors. Baseline/index GBV history and polyvictimization (intimate partner violence, non-partner sexual assault, and childhood sexual abuse) were characterized. Predictors of physical and sexual violence were evaluated over follow-up. Methods HIV-infected and uninfected participants (n=2,838) in the Women's Interagency HIV Study provided GBV history; 2,669 participants contributed 26,363 person years of follow-up from 1994 to 2014. In 2015–2016, multivariate log-binomial/Poisson regression models examined violence predictors, including GBV history, substance use, HIV status, and transactional sex. Results Overall, 61% reported index GBV history; over follow-up, 10% reported sexual and 21% reported physical violence. Having experienced all three forms of past GBV posed the greatest risk (adjusted incidence rate ratio [AIRR]physical=2.23, 95% CI=1.57, 3.19; AIRRsexual=3.17, 95% CI=1.89, 5.31). Time-varying risk factors included recent transactional sex (AIRRphysical=1.29, 95% CI=1.03, 1.61; AIRRsexual=2.98, 95% CI=2.12, 4.19), low income (AIRRphysical=1.22, 95% CI=1.01, 1.45; AIRRsexual=1.38, 95% CI=1.03, 1.85), and marijuana use (AIRRphysical=1.43, 95% CI=1.22, 1.68; AIRRsexual=1.57, 95% CI=1.19, 2.08). For physical violence, time-varying risk factors additionally included housing instability (AIRR=1.37, 95% CI=1.15, 1.62); unemployment (AIRR=1.38, 95% CI=1.14, 1.67); exceeding seven drinks/week (AIRR=1.44, 95% CI=1.21, 1.71); and use of crack, cocaine, or heroin (AIRR=1.76, 95% CI=1.46, 2.11). Conclusions Urban women living with HIV and their uninfected counterparts face sustained GBV risk. Past experiences of violence create sustained risk. Trauma-informed care, and addressing polyvictimization, structural inequality, transactional sex, and substance use treatment, can improve women's safety.

AB - Introduction Gender-based violence (GBV) threatens women's health and safety. Few prospective studies examine physical and sexual violence predictors. Baseline/index GBV history and polyvictimization (intimate partner violence, non-partner sexual assault, and childhood sexual abuse) were characterized. Predictors of physical and sexual violence were evaluated over follow-up. Methods HIV-infected and uninfected participants (n=2,838) in the Women's Interagency HIV Study provided GBV history; 2,669 participants contributed 26,363 person years of follow-up from 1994 to 2014. In 2015–2016, multivariate log-binomial/Poisson regression models examined violence predictors, including GBV history, substance use, HIV status, and transactional sex. Results Overall, 61% reported index GBV history; over follow-up, 10% reported sexual and 21% reported physical violence. Having experienced all three forms of past GBV posed the greatest risk (adjusted incidence rate ratio [AIRR]physical=2.23, 95% CI=1.57, 3.19; AIRRsexual=3.17, 95% CI=1.89, 5.31). Time-varying risk factors included recent transactional sex (AIRRphysical=1.29, 95% CI=1.03, 1.61; AIRRsexual=2.98, 95% CI=2.12, 4.19), low income (AIRRphysical=1.22, 95% CI=1.01, 1.45; AIRRsexual=1.38, 95% CI=1.03, 1.85), and marijuana use (AIRRphysical=1.43, 95% CI=1.22, 1.68; AIRRsexual=1.57, 95% CI=1.19, 2.08). For physical violence, time-varying risk factors additionally included housing instability (AIRR=1.37, 95% CI=1.15, 1.62); unemployment (AIRR=1.38, 95% CI=1.14, 1.67); exceeding seven drinks/week (AIRR=1.44, 95% CI=1.21, 1.71); and use of crack, cocaine, or heroin (AIRR=1.76, 95% CI=1.46, 2.11). Conclusions Urban women living with HIV and their uninfected counterparts face sustained GBV risk. Past experiences of violence create sustained risk. Trauma-informed care, and addressing polyvictimization, structural inequality, transactional sex, and substance use treatment, can improve women's safety.

UR - https://www.scopus.com/pages/publications/84994097192

U2 - 10.1016/j.amepre.2016.07.005

DO - 10.1016/j.amepre.2016.07.005

M3 - Article

C2 - 27595175

SN - 0749-3797

VL - 51

SP - 731

EP - 742

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

IS - 5

ER -

Physical and Sexual Violence Predictors: 20 Years of the Women's Interagency HIV Study Cohort

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