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Exploring the Linkages Between Spousal Violence and HIV in Five Sub-Saharan African Countries

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Gender-Based Violence

Abstract

There has been increasing recognition that spousal violence and HIV are overlapping vulnerabilities for many women. Yet a direct effect of most forms of spousal violence on women’s HIV status is unlikely, as there is no apparent causal pathway leading from one to the other. This study examines the relationship between spousal violence and women’s HIV status using Demographic and Health Surveys from five African countries: Kenya, Malawi, Rwanda, Zambia, and Zimbabwe. It uses couples data and nuanced measures of five separate forms of spousal violence. We adopt a gender-based framework in which a woman’s experience of spousal violence and her HIV status are mediated by her husband’s and her own behavioral and situational HIV risk factors, factors which are also shown to be associated with spousal violence. A series of regression models test for the direct effect of spousal violence, controlling for risk factors. An initial significant relationship with women’s HIV status is found for suspicion and isolation controlling behaviors in Zambia and Zimbabwe; for emotional violence in Kenya, Rwanda, and Zimbabwe; and for physical violence, in Kenya, Rwanda, and Zimbabwe. Sexual violence is not associated with women’s HIV status. Multiple associations between spousal violence and risk factors, and between these risk factors and women’s HIV status, suggest several possible mediators. When they are added to our base model, spousal violence no longer significantly predicts women’s HIV status with one exception: physical violence retains its association with women’s HIV status in Kenya and Zimbabwe.

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Notes

  1. 1.

    The reverse causal direction, that having HIV leads to spousal violence, cannot be ruled out with cross-sectional data, and a spurious correlation also is a possibility. However, the panel study conducted by Maman et al. (2010) lends credibility to the standard interpretation.

  2. 2.

    Some DHS questionnaires had an item about “threats or attacks with a knife or gun or any other weapon,” while others asked about “threats with a knife or gun” only. In one survey, respondents were asked about threats and attacks in separate items.

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Author information

Authors and Affiliations

  1. The DHS Program, Avenir Health, Glastonbury, CT, USA

    Kerry L. D. MacQuarrie

  2. The DHS Program, ICF International, Rockville, MD, USA

    Rebecca Winter & Sunita Kishor

Authors
  1. Kerry L. D. MacQuarrie
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  2. Rebecca Winter
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  3. Sunita Kishor
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Correspondence to Kerry L. D. MacQuarrie .

Editor information

Editors and Affiliations

  1. Department of Sociology, Anthropology and Geography, Auburn University at Montgomery, Montgomery, Alabama, USA

    Yanyi K. Djamba

  2. Department of Sociology, East Carolina University, Greenville, North Carolina, USA

    Sitawa R. Kimuna

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MacQuarrie, K.L.D., Winter, R., Kishor, S. (2015). Exploring the Linkages Between Spousal Violence and HIV in Five Sub-Saharan African Countries. In: Djamba, Y., Kimuna, S. (eds) Gender-Based Violence. Springer, Cham. https://doi.org/10.1007/978-3-319-16670-4_4

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