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HIV Rising in Women

The authors also note that despite reductions in the prevalence of infection among India's general population, women account for a rising percentage of all HIV cases, with husbands' risk behavior described as a major source of women's infection. They also point out that IPV has been linked to heterosexual transmission of HIV to women in India and elsewhere.

To assess the relationship between IPV and the occurrence of HIV infection, the investigators analyzed data on 28,139 married women who provided IPV data and HIV test results during November 2005 and August 2006 as part of a national family health survey.

A total of 35.4% of subjects reported experiencing physical abuse, with or without sexual violence, from their husbands. About one-quarter (27.8%) reported physical abuse without sexual violence, and 7.6% reported both physical and sexual abuse by their partners. Approximately 1 in 450 women (0.22%) were HIV positive.

Physical violence alone was not associated with risk of HIV infection, and the women's risk behaviors that were within their control, including condom use and multiple partners, were not associated with HIV infection.

According to the authors, the study's findings confirm research conducted in South Asia and Africa and further highlight the need for policy makers to consider domestic violence when formulating HIV prevention strategies in India and across the globe.

Such initiatives should educate women about IPV. However, the authors note, more important are innovative efforts aimed at men to change abusive and high-risk HIV behaviors.

"Thus far, major global initiatives to prevent HIV have not sufficiently recognized the potential of such problems to alter this critical element in the spread of HIV," they write.

The study was supported by the National Institute of Child Health and Human Development. The authors report no relevant disclosures.

JAMA. 2008;300:703-710. Abstract