�India is home to the third-largest number of human immunodeficiency virus (HIV) cases in the public and, as in the U.S. and many African nations, the rate of infection among women continues to ascend faster than that among men. In a modern study, researchers at the Harvard School of Public Health (HSPH) have establish that married Indian women who experienced physical and sexual abuse at the hands of their husbands were approximately four times more likely to become infected with HIV than married women who were not abused. This first large-scale, national study to examine the relationship 'tween intimate better half violence (IPV) against wives and clinically verified HIV infection appears in the August 13, 2008 outcome of JAMA.
The authors found that over 95% of HIV-positive married Indian women report being monogamous, confirming earlier studies suggesting that the most likely source of HIV infection among Indian women is husbands' extracurricular risk deportment, including unprotected extramarital sexual urge and sex with commercial sex workers. The finding that women who ar victims of partner fierceness are more likely to become HIV-infected is likely due to both the higher preponderance of extracurricular sexual behaviour among abusive as compared to non-abusive men, as well as an increased risk of HIV transmission to wives based on such men's abusive sexual practices within marriage.
"A women wHO is abused by her husband is truly set in a situation of 'double jeopardy' regarding HIV infection in that his sexual behavior outside of the marriage ceremony makes it more likely he is infected with the virus, and his abusive behavior inside the marriage leaves her with little control over sexual practice or sexual protection," said Jay Silverman, associate prof of society, human development and wellness at HSPH and lead author of the study.
Silverman, as well as researchers from the Indian Council of Medical Research (an authority of the Indian Ministry of Health and Family Welfare), Population Council in Delhi, and Boston University School of Public Health, analyzed data from the India National Family Health Survey conducted across all Indian states between 2005 and 2006. The study sample included 28,139 currently married women wHO were selected to both provide information on IPV and take part in HIV clinical testing.
The results showed that more than one third (35.5%) of the married Indian women reported experiencing physical violence with or without sexual ferocity from their husbands. Of these women, 27.8% experienced physical violence unparalleled, while 7.7% experient both physical and sexual abuse. The researchers base the danger for HIV infection among married women who experienced both forcible and sexual violence from their husbands was increased by a magnitude of 3.9 over the infection risk for women who were not ill-treated. Physical violence alone was not associated with risk of infection of HIV infection.
The study crataegus laevigata well induce important implications for public health policymakers and health care providers battling the oecumenical HIV/AIDS epidemic. "Those clinicians working to prevent HIV infection among their female patients should consider ferocity from male partners as an important risk component, and ask about and attempt to intervene in such clapperclaw to concentrate this risk," said Silverman. "More critically, major national and globose HIV prevention programs must include reduction men's IPV perpetration as a key target in the fight to root the epidemic."
He added that feminisation of HIV epidemics (that is, infections among women rising quicker than among men) in both the U.S. and Africa ar also considered, at least in contribution, to stem turn from women's inability to shield themselves from unprotected sex based on the controlling and abusive behavior of male partners.
"This study should serve as a wake call to us all. If we as policymakers and practitioners are passing to be truly successful in addressing the spread head of HIV in India, we must think of ways to address the all-too-widespread mistreatment of wives," added Dr. Donta Balaiah of the Indian Council of Medical Research.
This study was supported by the National Institute of Child Health and Human Development of the U.S. National Institutes of Health and the Indian Council of Medical Research.
"Intimate Partner Violence and HIV Infection Among Married Indian Women," Jay G. Silverman, Michele R. Decker, Niranjan Saggurti, Donta Balaiah, Anita Raj, JAMA, August 13, 2008, Vol. 300, No. 6
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