Journal of Urban Health

, 80:494 | Cite as

Does HIV status make a difference in the experience of lifetime abuse? descriptions of lifetime abuse and its context among low-income urban women

  • Karen A. McDonnell
  • Andrea Carlson Gielen
  • Patricia O’Campo
Original Articles: Various Topics


Women living in poor urban communities are doubly disadvantaged with regard to increased risk for two major public health crises in the United States today—HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) and violence. This study moves beyond the comparison of rates of lifetime abuse among women to incorporate contextual information of the abusive situation and experiences of HIV-positive women and a sample of sociodemographically similar HIV-negative women. A total of 611 women, 310 of whom were diagnosed as HIV positive, provided interviews integrating quantitative data and qualitative text on their lifetime experience of abuse. Quantitative results yielded few statistically significant differences between the lifetime experiences of violence between HIV-positive women and their HIV-negative counterparts. Of the women, 62% reported intimate partner violence, and 38% reported experiencing nonpartner abuse as an adult. A majority of the abused women reported that their alcohol or drug use or their partner’s alcohol or drug use was associated with the abuse experienced. Significant differences were found between HIV-positive women and HIV-negative women in the pattern of abuse experience as a child, the frequency of abuse as an adult, and the involvement of women’s drinking before or during a violent episode. Qualitative excerpts from the interviews were found to differ thematically and were integrated with the quantitative data to provide a more comprehensive understanding of the women’s contextual situation in understanding interpersonal violence experienced by both HIV-positive and HIV-negative women.


Childhood abuse Drugs and alcohol Females HIV/AIDS Intimate partner violence Physical abuse Sexual abuse 


  1. 1.
    Gielen AC, McDonnell KA, Burke JG, O’Campo P. Women’s lives after and HIV positive diagnosis: disclosure and violence. Matern Child Health J. 2000;4:111–120.CrossRefPubMedGoogle Scholar
  2. 2.
    Choi KH, Binson D, Adelson M, Catania J. Sexual harassment, sexual coercion and HIV risk among US adults 18–49 years. AIDS Behav. 1998;2:33–40.CrossRefGoogle Scholar
  3. 3.
    Gielen AC, McDonnell KA, Wu A, Faden R, O’Campo P. Psychosocial correlates of quality of life among women living with HIV: implications for intervention. Soc Sci Med. 2001;52:315–322.CrossRefPubMedGoogle Scholar
  4. 4.
    Gielen AC, O’Campo P, Faden RR, Eke A. Women’s disclosure of HIV status: experiences of mistreatment and violence in an urban setting. Women Health. 1997;25:19–31.CrossRefPubMedGoogle Scholar
  5. 5.
    Kalichman SC, Williams EA, Cherry C, Belcher L, Nachimson D. Sexual coercion, domestic violence and negotiating condom use among low-income African American women. J Womens Health. 1998;85:1251–1525.Google Scholar
  6. 6.
    Molina L, Basinait-Smith C. Letters to the editor: revisiting the intersection between domestic abuse and HIV risk. Am J Public Health. 1998;88:1267–1268.PubMedCrossRefGoogle Scholar
  7. 7.
    North RL, Rothenberg KH. Partner notification and the threat of domestic violence against women with HIV infection. N Engl J Med. 1993;329:1194–1196.CrossRefPubMedGoogle Scholar
  8. 8.
    Rothenberg KH, Paskey SJ, Reuland MM, Zimmerman SI, North RL. Domestic violence and partner notification: Implications for treatment and counseling of women with HIV. J Am Med Womens Assoc. 1995;50:87–93.PubMedGoogle Scholar
  9. 9.
    Zierler S, Cunningham WE, Andersen R, et al. Violence victimization after HIV infection in a US probability sample of adult patients in primary care. Am J Public Health. 2000;90:208–215.PubMedCrossRefGoogle Scholar
  10. 10.
    Zieler S, Witbeck B, Mayer K. Sexual violence against women living with or at risk for HIV infection. Am J Prev Med. 1996;12:304–310.Google Scholar
  11. 11.
    Maman S, Campbell J, Sweat MD, Gielen AC. The intersections of HIV and violence: directions for future research and interventions. Soc Sci Med. 2000;50:459–478.CrossRefPubMedGoogle Scholar
  12. 12.
    Wyatt GE, Myers HF, Williams JK, et al. Does a history of trauma contribute to HIV risk for women of color? Implication for intervention and policy. Am J Public Health. 2002;92:660–665.PubMedCrossRefGoogle Scholar
  13. 13.
    Kimerling R, Goldsmith R. Links between exposure to violence and HIV-infection: implications for substance abuse treatment with women. Alcohol Treat Q. 2000;18:61–69.CrossRefGoogle Scholar
  14. 14.
    Garcia-Moreno C, Watts C. Violence against women: its importance for HIV/AIDS. AIDS. 2000;14:S253–S265.PubMedGoogle Scholar
  15. 15.
    El-Bassel N, Gilbert L, Rajah V, Foleno A, Frye V. Fear and violence: raising the HIV stakes. AIDS Educ Prev. 2000;12:154–170.PubMedGoogle Scholar
  16. 16.
    Wyatt GE, Axelrod J, Chin D, et al. Examining patterns of vulnerability to domestic violence among African American women. Violence Against Women. 2000;6:495–514.CrossRefGoogle Scholar
  17. 17.
    Cohen M, Deamant C, Barkan S, et al. Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV. Am J Public Health. 2000;90: 560–565.PubMedCrossRefGoogle Scholar
  18. 18.
    Vlahov D, Wientge D, Moore J, et al. Violence against women with or at risk for HIV infection. AIDS Behav. 1998;2:53–60.CrossRefGoogle Scholar
  19. 19.
    Axelrod J, Myers HF, Durvasula R, et al. The impact of relationship violence, HIV, and ethnicity on adjustment in women. Cultur Divers Ethni Minor Psychol. 1999;5: 263–275.CrossRefGoogle Scholar
  20. 20.
    Lodico M, DiClemente R. The association between childhood sexual abuse and prevalence of HIV-risk related behaviors. Clin Pediatr. August 1994: 498–502.CrossRefGoogle Scholar
  21. 21.
    Wingood GM, DiClemente RJ. Rape among African American women: sexual psychological, and social correlated predisposing survivors to risk of STD/HIV. J Womens Health, 1998;7:77–84.PubMedCrossRefGoogle Scholar
  22. 22.
    Zierler S, Feingod L, Laufer D, et al. Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. Am J Public Health. 1991;81:572–575.PubMedCrossRefGoogle Scholar
  23. 23.
    El-Bassel N, Witte SS, Wada T, Gilbert L, Wallace J. Correlates of partner abuse among female street-based sex workers; substance abuse, history of childhood abuse and HIV risks. AIDS Patient Care STDs. 2001;15:41–51.CrossRefPubMedGoogle Scholar
  24. 24.
    Smith JW. Addiction medicine and domestic violence. J Subst Abuse Treat. 2000;19: 329–338.CrossRefPubMedGoogle Scholar
  25. 24.
    Augerbraun M, Wilson TE, Allister L. Domestic violence reported by women attending a sexually transmitted disease clinic. Sex Transm Dis. 2001;28:143–147.CrossRefGoogle Scholar
  26. 25.
    Brewer DD, Fleming CB, Haggerty KP, Catalano RF. Drug use predictors of partner violence in opiate-dependent women. Violence Vict. 1998;13:107–115.PubMedGoogle Scholar
  27. 27.
    Martin SL, Clark KA, Lynch SR, Kupper LL, Cilenti D. Violence in the lives of pregnant teenage women: associations with multiple substance use. Am J Drug Alcohol Abuse. 1999;25:425–440.CrossRefPubMedGoogle Scholar
  28. 28.
    Bhatt RV. Domestic violence and substance abuse. Int J Gynaecol Obstet. 1998;63: S25–S31.CrossRefPubMedGoogle Scholar
  29. 29.
    He H, McCoy HV, Stevens SJ, Stark MJ. Violence and HIV sexual risk behaviors among female sex partners of male drug users. Women Health. 1998;27:161–175.CrossRefPubMedGoogle Scholar
  30. 30.
    Plichta SB. Violence and abuse: implications for women’s health. In Falik MM, Collins KS, eds. Women’s Health: The Commonwealth Survey. Baltimore, MD: Johns Hopkins University Press; 1996:237–272.Google Scholar
  31. 31.
    Plichta SB, Falik M. Prevalence of violence and its implication for women’s health. Womens Health Issues. 2001;11:244–258.CrossRefPubMedGoogle Scholar
  32. 32.
    Jones AS, Gielen AC, Campbell JC, et al. Annual and lifetime prevalence of partner abuse in a sample of female HMO enrollees. Womens Health Issues. 1999;9:295–305.CrossRefGoogle Scholar
  33. 33.
    Tjaden P, Thoennes N. Prevalence, Incidence, and Consequences of Violence Against Women: Findings From the National Violence Against Women Survey. Washington, DC: National Institute of Justice, Centers for Disease Control and Prevention; 1998.Google Scholar
  34. 34.
    QSR NUD * IST. Software for Qualitative Data Analysis. Thousand Oaks, CA: Scolari; 1997.Google Scholar
  35. 35.
    Crowell NA, Burgess, AW. Understanding Violence Against Women. Washington, DC: National Academy of Sciences, American Psychological Association; 1996.CrossRefGoogle Scholar
  36. 36.
    Heise L, Ellsberg M, Gottenmoeller M. Ending Violence Against Women. Population Reports, Series L, No. 11. Baltimore, MD: Johns Hopkins University, School of Public Health, Population Information Program; 1999.Google Scholar
  37. 37.
    Gilbert L, El-Bassel N, Schilling RF, Friedman E. Childhood abuse as a risk factor for partner abuse among women in methadone maintenance. A J Drug Alcohol Abuse. 1997;23:581–595.CrossRefGoogle Scholar
  38. 38.
    Koenig LJ, Whitaker DJ, Royce RA, Wilson TE, Callahan MR, Fernandez MI. Violence during pregnancy among women with or at risk for HIV infection. Am J Public Health. 2002;92:367–370.PubMedCrossRefGoogle Scholar
  39. 39.
    Kyriacou DN, Anglin D, Taliaferro E, et al. Risk factors for injury to women from domestic violence. N Engl J Med. 1999;341:1892–1898.CrossRefPubMedGoogle Scholar
  40. 40.
    Grisso JA, Schwarz DF, Hirschinger N, et al. Violent injuries among women in an urban area. N Engl J Med. 1999;341:1899–1905.CrossRefPubMedGoogle Scholar
  41. 41.
    Gielen AC, McDonnell KA, O’Campo P. Intimate partner violence, HIV status, and sexual risk reduction. AIDS Behav. 2002;6:107–116.CrossRefGoogle Scholar
  42. 42.
    Zierler S, Krieger N. Reframing women’s risk: social inequalities and HIV infection. Annu Rev Public Health. 1997;18:401–436.CrossRefPubMedGoogle Scholar
  43. 43.
    Wingood G, DiClemente R. The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. Am J Public Health. 1997;87:1016–1018.PubMedCrossRefGoogle Scholar
  44. 44.
    McDonnell KA, Gielen AC, Wu A, O’Campo P, Faden R. Measuring health related quality of life among women living with HIV. Qual Life Res. 2000;9:931–940.CrossRefPubMedGoogle Scholar

Copyright information

© The New York Academy of Medicine 2003

Authors and Affiliations

  • Karen A. McDonnell
    • 1
  • Andrea Carlson Gielen
  • Patricia O’Campo
  1. 1.Maternal and Child Health ProgramGeorge Washington University SPHHSWashington, DC

Personalised recommendations