[Viva] Fwd: CATIE News - Domestic violence against HIV-positive women and its impact on their health

Tue Sep 3 21:15:06 PDT 2013

I think they are very sad indeed Peggy.  I am just sorry to be the bearer
of bad tidings.
Denise

On Tue, Sep 3, 2013 at 8:58 PM, Peggy Frank <pegfrank at telus.net> wrote:

> These results are shocking and not only suggest more care for women but
> also a need to look closer at the cause of HIV-related stigma.
>
> Thanks to researchers for embracing these studies and to friends like you
> who pass them along.  Let's continue to support each other to stay strong,
> centred and not isolated.  -peg
> On 2013-09-03, at 8:26 PM, Denise Becker wrote:
>
>
>
> ---------- Forwarded message ----------
> From: CATIE <mailer at newsletter.catie.ca>
> Date: Tue, Sep 3, 2013 at 2:30 PM
> Subject: CATIE News - Domestic violence against HIV-positive women and its
> impact on their health
> To: dbecker106 at gmail.com
>
>
> **
>     CATIE News - Bite-sized HIV/AIDS news bulletins
>        CATIE News - Domestic violence against HIV-positive women and its
> impact on their health
>
> Several terms are used by researchers who study violence against women
> committed by men who are their partners. Examples of such terms include the
> following:
>
>    - domestic violence
>    - gender-based violence
>    - intimate partner violence (IPV)
>
> The United States Institute of Medicine (IOM) now recommends that
> healthcare professionals screen and counsel all women for IPV.
>
> Past research in sub-Saharan Africa, India and the U.S. has found that IPV
> is a risk factor for women acquiring HIV. However, little research has been
> done to explore the impact of IPV on the health of HIV-positive women.
>
> Now researchers in Calgary, Alberta, have conducted a study to assess the
> presence of IPV among HIV-positive women as well as its impact on their
> health. Their findings are distressing—IPV is common, reported by 40% of
> HIV-positive women in the region’s major clinic. Furthermore, HIV-positive
> women who disclosed IPV had worse health and quality of life compared to
> other HIV-positive women who did not report IPV. Indeed, HIV-positive women
> who reported IPV were more likely to have been hospitalized even after
> initiating care for HIV.
>
> The present study has uncovered a high rate of IPV among HIV-positive
> women and documented a link to increased hospitalization in affected women.
> Hospital stays arising from any cause, including IPV, are costly for the
> healthcare system. These factors should encourage policy planners and
> regional health departments to intensify programs to help prevent IPV and
> treat women, particularly those with HIV, affected by abuse. By building a
> trusting relationship with HIV-positive women, healthcare providers can
> help engage these women into care and improve the women’s overall health
> and well-being.
>  Study details
>
> The Alberta research team noted that there are several types of abuse that
> can be directed at people, including the following:
>
>    - physical abuse
>    - sexual abuse
>    - emotional abuse
>    - financial abuse
>    - isolation
>    - neglect
>    - intimidation
>
> As part of their study, the research team screened HIV-positive women for
> these types of abuse during the course of routine clinic visits between May
> 2009 and Jan 2012. Any woman who disclosed abuse was offered further care
> with a social worker who had expertise dealing with IPV among HIV-positive
> people.
>  Results
>
> Nearly 80% (339 women) of women receiving HIV care in Southern Alberta
> were screened for abuse during the study. The main findings were as follows:
>
>    - 40% (137) of women reported a history of IPV
>    - among the 137 women who disclosed a history of abuse, 20% reported
>    that abuse occurred in their current relationship
>    - 8% (11) of women who experienced abuse disclosed that abuse occurred
>    both in their past and current relationships
>    - 22% of the 137 women who reported a history of IPV also disclosed a
>    history of childhood abuse
>
> Common forms of abuse included the following:
>
>    - emotional
>    - physical
>    - sexual
>
> However, the researchers stated that most women (72%) disclosed that they
> “experienced multiple types of abuse."
>  Race and ethnicity
>
> The research team found that Aboriginal and white women reported high
> rates of IPV as follows:
>
>    - Aboriginal women – 65%
>    - white women – 61%
>
> In contrast, black women, most of whom were immigrants from sub-Saharan
> Africa, reported a lower rate of IPV (22%).
>  IPV, substance use and imprisonment
>
> The researchers found that women who had a history of IPV were
> significantly more likely to do the following:
>
>    - use street drugs
>    - use tobacco or have a history of smoking
>
> The research team found that IPV did not predict the “excessive” use of
> alcohol.
>
> The study was mostly cross-sectional in nature; this is akin to taking a
> snapshot of a group of people at one time and studying the data captured,
> rather than conducting a longer and more expensive study that monitors
> participants for many years. As a result of the nature of the study, the
> timing of substance use in relation to abuse is not clear. However, it is
> likely that substance use occurred after IPV as women sought temporary
> refuge from the psychological burden imposed by abuse.
>
> The researchers found it noteworthy that 19 out of 25 women who had a
> history of being imprisoned reported IPV.
>  Mental health
>
> In reviewing the medical records of the women in the study, researchers
> found that women who experienced IPV had high rates of depression prior to
> their HIV diagnosis. In general, the intensity of depression was severe and
> many affected women required prescription medicines to cope.
>
> Women who had IPV also had an increased risk for previously being
> diagnosed with an anxiety-related disorder. Furthermore, women with IPV
> were more likely to have attempted to commit suicide before having been
> diagnosed with HIV.
>  Quality of life
>
> Women who reported IPV had greatly reduced health-related quality of life.
>  General health
>
> Women who disclosed IPV were generally diagnosed with HIV relatively early
> in the course of infection, with CD4+ counts greater than 500 cells. Also,
> women who disclosed IPV were less likely to use antiretroviral therapy
> (commonly called ART or HAART); if they did use it, they did so
> irregularly. Moreover, women who experienced IPV found it difficult to stay
> engaged with regular clinic visits and other care. Over the long term, such
> interruptions in care could affect their survival.
>
> Rates of hospitalization were greater for women with IPV than women who
> did not have IPV.
>  Key findings
>
> The Alberta study has found a high overall rate—40%—of IPV among
> HIV-positive women. According to the researchers, it is possible that the
> actual rate of IPV is even greater: “Many women experiencing IPV do not
> interpret their experiences as IPV, often minimizing the situation.”
>
> The researchers also found that substance use and a history of smoking
> were relatively common among women who disclosed IPV. They stated that
> “helping patients address IPV in a constructive manner may also [reduce the
> illness and death that can arise from] substance use and smoking.”
>
> Another finding noted by researchers was that women who faced IPV
> “experience multiple barriers to care, such as the immediate threats to the
> safety of themselves and their dependents, which in turn requires less
> imminent threats, such as HIV infection, to fall in priority.”
>
> The researchers stated that many women “may also experience IPV as a
> consequence of HIV infection and its disclosure [to their partner]. As
> such, these women may be risking violent repercussions by engaging in care.
> Our study supports this [idea], as women who experienced IPV found it more
> difficult to remain engaged in HIV care.”
>
> In this context it is not surprising that many women with IPV had poor
> health and quality of life, in part due to severe stress and no or
> intermittent use of ART. So the Alberta team proposes that by “directly
> addressing IPV, we may support adherence to care and thereby improve [their
> health and well-being].”
>  Advice for care teams
>
> Women who disclosed IPV were less likely to be using ART; this may have at
> least partially accounted for their increased risk for hospitalization.
> Therefore, the researchers encourage medical and social teams caring for
> HIV-positive women to help develop safe and trustworthy relationships so
> that care teams can address IPV and its psychological consequences. As a
> result, affected women should improve psychologically and be able to take
> ART exactly as directed, which would lead to them experiencing better
> health and quality of life. Physicians, nurses, pharmacists and other
> healthcare providers can begin to help women with IPV by “appropriate
> referrals to specialized agencies and other health professionals” who are
> trained and experienced in dealing with IPV.
>
> The Alberta study is a good first step in tackling the horror of IPV among
> HIV-positive women. Further research is needed to study the long-term
> outcomes on the health of affected HIV-positive women who have been able to
> disclose and escape IPV. As well, more effort needs to be made by regional
> health authorities everywhere to educate and screen all women about IPV.
>
> *—Sean R. Hosein*
>
> REFERENCES:
>
>    1. Siemieniuk RA, Krentz HB, Miller P, et al. The clinical
>    implications of high rates of intimate partner violence against
>    HIV-positive women. *Journal of Acquired Immune Deficiency Syndromes*.
>    2013 Sep 1;64(1):32-8.
>    2. Siemieniuk RA, Krentz HB, Gill MJ. Intimate partner violence and
>    HIV: a review. *Current HIV/AIDS Reports.* 2013; *in press*.
>
>
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> --
> www.denise-becker.com
> Queen's Gold Jubilee Medal
> Queen's Diamond Jubilee Medal
> cell: 250-870-1714
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>
> Peggy Frank
> http://peggyfrank.blogspot.ca/
>
> A kite won't fly unless it's free.
>
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-- 
www.denise-becker.com
Queen's Gold Jubilee Medal
Queen's Diamond Jubilee Medal
cell: 250-870-1714
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