Skip to main content

Advertisement

SpringerLink
Log in

Sexual Risk, Serostatus and Intimate Partner Violence Among Couples During Pregnancy in Rural South Africa

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The aim of this study was to describe sexual risk behavior among 239 couples during pregnancy and to examine the relationship of sexual risk behavior with HIV serostatus and intimate partner violence. One-third (31.8 %) of pregnant women and 20.9 % of male partners were HIV positive. HIV risk factors included lack of knowledge of partners’ HIV serostatus, unprotected sexual intercourse and multiple sexual partners. Among men, multivariate logistic regression identified awareness of HIV negative partner status, multiple sexual partners and low levels of partner violence and among women Zulu or Swati ethnicity were associated with unprotected intercourse. HIV positive concordance was associated with protected sex and in multilevel analysis of couples HIV positive status and awareness of the partner’s HIV positive status were associated with protected sex. High levels of HIV risk behaviour was found among couples during pregnancy calling for HIV risk reduction interventions.

Resumen

La meta de este estudio fue describir la conducta sexual de riesgo de 239 parejas durante el embarazo, y examinar la relación entre la conducta sexual de riesgo y VIH serostatus y la violencia doméstica. Un tercio (31.8 %) de las mujeres embarazadas y 20.9 % de las parejas masculinas eran VIH positivo. Los factores de riesgo de VIH incluyeron falta de conocimiento de VIH serostatus de la pareja, relación sexual sin protección y parejas sexuales múltiples. Entre los hombres, regresión logística multivariable identificó conciencia del estado de VIH negativo de la pareja, parejas sexuales múltiples y niveles bajos de violencia doméstica, y entre mujeres, la etnicidad Zulú o Swati fue asociada con relación sexual sin protección. Concordancia de VIH positivo fue asociada con sexo con protección, y en análisis de multiniveles de parejas, el estado VIH positivo y la conciencia del estado VIH positivo de la pareja fueron asociados con sexo con protección. Altos niveles de conducta de riesgo de VIH fueron encontrados entre parejas durante el embarazo, pidiendo intervenciones para reducir el riesgo de VIH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nicolosi A, Leite MLC, Musicco M, Arici C, Gavazzeni G, Lazzarin A. The efficiency of male-to-female and female-to-male sexual transmission of the Human Immunodeficiency Virus: a study of 730 stable couples. Epidemiology. 1994;5(6):570–5.

    Article  PubMed  CAS  Google Scholar 

  2. Otwombe KN, Ndindi P, Ajema C, et al. Using VCT statistics from Kenya in understanding the association between gender and HIV. SAHARA J. 2007;4(3):110–5.

    Article  Google Scholar 

  3. Mugo NR, Heffron R, Donnell D, et al. Increased risk of HIV-1 transmission in pregnancy: a prospective study among African HIV-1-serodiscordant couples. AIDS. 2011;25(15):1887–95.

    Article  PubMed  Google Scholar 

  4. Gray RH, Li X, Kigozi G, et al. Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366(9492):1182–8.

    Article  PubMed  Google Scholar 

  5. Desgrées du Loû A, Msellati P, Ramon R, et al. HIV-1 infection and reproductive history: a retrospective study among pregnant women, Abidjan, Côte d’Ivoire, 1995–1996. Ditrame Project. Int J STD AIDS. 1998;9(8):452–6.

  6. Brocklehurst P, French R. The association between maternal HIV infection and perinatal outcome: a systematic review of the literature and meta-analysis. Br J Obstet Gynaecol. 1998;105(8):836–48.

    Article  PubMed  CAS  Google Scholar 

  7. Senkumwong N, Chaovisitsaree S, Rugpao S, et al. The changes of sexuality in Thai women during pregnancy. J Med Assoc Thail. 2006;89(4):S124–9.

    Google Scholar 

  8. Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med. 2010;7(1 Pt 1):136–42.

    Article  PubMed  Google Scholar 

  9. Bartellas E, Crane JM, Daley M, et al. Sexuality and sexual activity in pregnancy. Br J Obstet Gynaecol. 2000;107(8):964–8.

    Article  CAS  Google Scholar 

  10. Onoya D, Reddy P, Sifunda S, et al. Comparing STI risk and sexual behaviour profiles of pregnant versus non-pregnant, HIV negative black south African women. WebmedCentral PUBLIC HEALTH 2010;1(11):WMC001142.

    Google Scholar 

  11. Manenti SA, Galato JJ, Silveira ES, et al. Epidemiologic and clinical characteristics of pregnant women living with HIV/AIDS in a region of Southern Brazil where the subtype C of HIV-1 infection predominates. Braz J Infect Dis. 2011;15(4):349–55.

    PubMed  Google Scholar 

  12. Brubaker SG, Bukusi EA, Odoyo J, et al. Pregnancy and HIV transmission among HIV-discordant couples in a clinical trial in Kisumu, Kenya. HIV Med. 2011;12(5):316–21. doi:10.1111/j.1468-1293.2010.00884.x.

    Article  PubMed  CAS  Google Scholar 

  13. Schwartz SR, Mehta SH, Taha TE, Rees HV, Venter F, Black V. High Pregnancy Intentions and Missed opportunities for Provider communication about fertility in a South African cohort of HIV positive women on antiretroviral therapy. AIDS Behav. 2011;. doi:10.1007/s10461-011-9981-3.

    Google Scholar 

  14. Anglewicz PA, Bignami-Van Assche S, Clark S, et al. HIV risk among currently married couples in rural Malawi: What do spouses know about each other? AIDS Behav. 2010;14(1):103–12.

    Article  PubMed  Google Scholar 

  15. Ackermann L, de Klerk K. Social factors that make South African women vulnerable to HIV infection. Health Care Women Int. 2002;3:163–72.

    Article  Google Scholar 

  16. Maman S, Mbwambo JK, Hogan NM, et al. HIV-positive women report more lifetime partner violence: findings from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. Am J Public Health. 2002;92:1331–552.

    Article  PubMed  Google Scholar 

  17. Pettifor AE. Sexual power and HIV risk, South Africa. Emerg Infect Dis. 2004;10(11):1996–2004.

    Article  PubMed  Google Scholar 

  18. Harvey SM, Bird ST, Galavotti C, et al. Relationship power, sexual decision-making, and condom use among women at risk for HIV/STDs. Women Health. 2002;36(4):69–84.

    Article  PubMed  Google Scholar 

  19. Dunkle KL, Jewkes RK, Brown HC, et al. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet. 2004;363(9419):1415–21.

    Article  PubMed  Google Scholar 

  20. Kalichman SC, Rompa D, Luke W, et al. HIV transmission risk behaviors among HIV-positive persons in serodiscordant relationships. Int J STD AIDS. 2002;13(10):677–82.

    Article  PubMed  Google Scholar 

  21. El-Bassel N, Witte SS, Gilbert L, et al. The efficacy of a relationship-based HIV/STD prevention program for heterosexual couples. Am J Public Health. 2003;93(6):963–9.

    Article  PubMed  Google Scholar 

  22. Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV knowledge questionnaire (HIV-KQ-18). AIDS Educ Prev. 2002;14:174–84.

    Article  Google Scholar 

  23. Peltzer K, Mlambo G, Phaweni K. Factors determining prenatal HIV testing for prevention of mother to child transmission of HIV in Mpumalanga, South Africa. AIDS Behav. 2010;14(5):1115–23.

    Article  PubMed  Google Scholar 

  24. Meyer-Bahlberg HFL, Ehrhardt AA, Exner TM, et al. Sexual risk behavior assessment schedule: adult. (SERBAS-A-DF-4) manual. New York: Psychological Press; 1990.

  25. Straus MA. Measuring intrafamily conflict and violence. J Marriage Fam. 1979;41:75–88.

    Article  Google Scholar 

  26. Strauss MA, Hamby SL, Boney-McCoy S. The revised conflict tactics scales (CTS2): development and preliminary psychometric data. J Fam Issues. 1996;17(3):283–316.

    Article  Google Scholar 

  27. Bennetts A, Shaffer N, Phophong P, et al. Differences in sexual behaviour between HIV-infected pregnant women and their husbands in Bangkok, Thailand. AIDS Care. 1999;11(6):649–61.

    Article  PubMed  CAS  Google Scholar 

  28. Kershaw TS, Small M, Joseph G, Theodore M, Bateau R, Frederic R. The influence of power on HIV risk among pregnant women in rural Haiti. AIDS Behav. 2006;10(3):309–18.

    Article  PubMed  Google Scholar 

  29. Department of Health. National Antenatal Sentinel HIV and Syphilis Prevalence Survey in South Africa, 2010. Pretoria: Department of Health; 2011.

    Google Scholar 

  30. Mlambo M, Peltzer K. HIV sero-status disclosure and sexual behaviour among HIV positive patients who are on antiretroviral treatment (ART) in Mpumalanga, South Africa. J Hum Ecol. 2011;35(1):29–41.

    Google Scholar 

Download references

Acknowledgments

The study is funded by the National Institute of Allergy and Infectious Diseases, grant number P30AI073961-S2.

Author information

Authors and Affiliations

  1. HIV/AIDS/STI and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa

    Karl Peltzer & Elisa Shikwane

  2. Department of Psychology, University of Limpopo, Turfloop, South Africa

    Karl Peltzer

  3. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Deborah Jones, Stephen M. Weiss & Olga Villar-Loubet

Authors
  1. Karl Peltzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deborah Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen M. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Olga Villar-Loubet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elisa Shikwane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karl Peltzer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Peltzer, K., Jones, D., Weiss, S.M. et al. Sexual Risk, Serostatus and Intimate Partner Violence Among Couples During Pregnancy in Rural South Africa. AIDS Behav 17, 508–516 (2013). https://doi.org/10.1007/s10461-012-0185-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-012-0185-2

Keywords

Palabras claves

Search

Navigation