Predictors of intimate partner violence perpetration and onward HIV transmission among adolescent boys in Soweto, South Africa
1. Abstracts based on Formal Research WorkPhumla Madi1, Avy Violari1, Busisiwe Nkala2, Amy Hammock3, 4, Janan J Dietrich1, 5, Stefanie Hornshuh1, Rachel Kidman3, 6
1 Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
2 Department of Social Work, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
3 Program in Public Health, State University of New York at Stony Brook, Stony Brook, New York
4 School of Social Welfare, State University of New York at Stony Brook, Stony Brook, NY
5 African Social Sciences Unit of Research and Evaluation (ASSURE), Division of Wits Health Consortium, Johannesburg, South Africa and Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa
6 Department of Family, Population and Preventive Medicine, State University of New York at Stony Brook, Stony Brook, New York
Abstract
Purpose: Intimate partner violence (IPV) and HIV incidence rises substantially during adolescence. South Africa has among the world’s highest rates of IPV and HIV, where 27% of girls (aged 15) reported IPV victimisation, and 720 000 adolescents are living with HIV. Moreover, these risks are intertwined, with IPV perpetration potentially driving HIV onward transmission among adolescents, and vice versa. Here we examine the prevalence of IPV perpetration by adolescent boys living with perinatally-acquired HIV (PHIV) and their uninfected peers. We then examine possible predictors of IPV perpetration in this age group.
Methods: Tsamaisano is a longitudinal study taking place in Soweto, South Africa. Participants (N=498; 251 PHIV and 247 HIV-uninfected) ages 15 to 19 years were recruited between November 2020 – May 2022. Participants completed an electronic self-report survey at enrolment, and weekly mobile surveys over 52 weeks on their mobile phones. The participants had to be in a dating relationship where they saw their partner face-to-face, or at the time of enrolment, report having had sex in the last month. Here we report on the baseline findings of lifetime and past year IPV perpetration and associated factors, specifically HIV status, age, PTSD, gender ideology and age of sexual debut. We define IPV as emotional, sexual and physical violence by a current or ex-partner. Frequency and logistic regressions were done.
Results: Lifetime and past year IPV perpetration was reported by 52% and 13% of adolescent boys respectively, with emotional IPV being most frequently reported (lifetime: 39%; past-year: 26%) followed by sexual (lifetime: 27%; past-year: 13%), and then by physical (lifetime: 17%; past-year: 10%). Emotional IPV perpetrators were more likely to be HIV-uninfected (odds ratio (OR) 1.52; 95% confidence interval (CI) 1.02 – 2.28) and older (OR 1.17; CI 1.01-1.35). Neither HIV status nor age were significant predictors of physical or sexual IPV perpetration. Ongoing analyses are exploring other pertinent potential predictors (i.e. PTSD, gender ideology) in order to identify points for intervention. Further analyses and insights will be available prior to the conference.
Conclusion: Reports of IPV perpetration across this age group were high. Factors such as PTSD and gender ideology, particularly in times of conflict, need to be identified and managed among this age group. Adolescents living with HIV is a growing number. Despite seeing no differences by HIV status, PHIV should be included in IPV and counselling programs to potentially reduce onward HIV transmission.