Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda

Amanda P. Miller; Eileen V. Pitpitan; Dorean Nabukalu; Fred Nalugoda; Gertrude Nakigozi; Godfrey Kigozi; Mary Kate Grabowski; Caitlin E. Kennedy; Jennifer A. Wagman

doi:10.1007/s10461-020-03069-9

Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda

Amanda P. Miller, Eileen V. Pitpitan, Dorean Nabukalu, Fred Nalugoda, Gertrude Nakigozi, Godfrey Kigozi, Mary Kate Grabowski, Caitlin E. Kennedy, Jennifer A. Wagman

Research output: Contribution to journal › Article › peer-review

Abstract

Transactional sex (TS) is prevalent in sub-Saharan Africa. Women’s engagement in TS is linked with HIV infection; little is known about the relationship between TS, intimate partner violence (IPV) and alcohol use—established HIV risk behaviors. Using modified Poisson regression, we assessed associations between TS and physical, verbal and sexual IPV among 8248 women (15–49 years) who participated in the Rakai Community Cohort Study across forty communities in Uganda. An interaction term assessed moderation between alcohol use and TS and no significant interaction effects were found. In adjusted analysis, alcohol use and TS were significantly associated with all forms of IPV. In stratified analysis, TS was only associated with IPV in agrarian communities; alcohol use was not associated with physical IPV in trade communities or sexual IPV in trade and fishing communities. Identifying differences in IPV risk factors by community type is critical for the development of tailored interventions.

Original language	English (US)
Pages (from-to)	1144-1158
Number of pages	15
Journal	AIDS and behavior
Volume	25
Issue number	4
DOIs	https://doi.org/10.1007/s10461-020-03069-9
State	Published - Apr 2021

Keywords

Alcohol use
HIV
Intimate partner violence
Sub-Saharan Africa
Transactional sex
Uganda

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1007/s10461-020-03069-9

Cite this

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title = "Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda",

abstract = "Transactional sex (TS) is prevalent in sub-Saharan Africa. Women{\textquoteright}s engagement in TS is linked with HIV infection; little is known about the relationship between TS, intimate partner violence (IPV) and alcohol use—established HIV risk behaviors. Using modified Poisson regression, we assessed associations between TS and physical, verbal and sexual IPV among 8248 women (15–49 years) who participated in the Rakai Community Cohort Study across forty communities in Uganda. An interaction term assessed moderation between alcohol use and TS and no significant interaction effects were found. In adjusted analysis, alcohol use and TS were significantly associated with all forms of IPV. In stratified analysis, TS was only associated with IPV in agrarian communities; alcohol use was not associated with physical IPV in trade communities or sexual IPV in trade and fishing communities. Identifying differences in IPV risk factors by community type is critical for the development of tailored interventions.",

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note = "Funding Information: The authors would like to thank the Rakai Community Cohort Study participants for their time. This project was supported by National Institute on Alcohol Abuse and Alcoholism Grants K01AA024068 (PI: Wagman) and F31AA028198-01 (PI: Miller), National Institute on Drug Abuse Grant R01AA018074 (PI: Pitpitan), National Institute of Mental Health Grant R01MH105313 (PI: Kennedy), National Institute of Allergy and Infectious Diseases Grant K01AI125086 (PI: Grabowski) and an award from the UC San Diego Global Health Institute (PI: Wagman). The Rakai Community Cohort Study field costs were supported by National Institute on Child Health and Human Development Grant 5RO1 HD072695 (PI: Santelli), National Institute of Allergy and Infection Diseases Grant R01AI114438 (PI: Wawer), and National Institutes of Health Coordinating Office of Global Health award 5U2GGH000817 (PI: Serwadda). Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

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doi = "10.1007/s10461-020-03069-9",

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AU - Nalugoda, Fred

AU - Nakigozi, Gertrude

AU - Kigozi, Godfrey

AU - Grabowski, Mary Kate

AU - Kennedy, Caitlin E.

AU - Wagman, Jennifer A.

N1 - Funding Information: The authors would like to thank the Rakai Community Cohort Study participants for their time. This project was supported by National Institute on Alcohol Abuse and Alcoholism Grants K01AA024068 (PI: Wagman) and F31AA028198-01 (PI: Miller), National Institute on Drug Abuse Grant R01AA018074 (PI: Pitpitan), National Institute of Mental Health Grant R01MH105313 (PI: Kennedy), National Institute of Allergy and Infectious Diseases Grant K01AI125086 (PI: Grabowski) and an award from the UC San Diego Global Health Institute (PI: Wagman). The Rakai Community Cohort Study field costs were supported by National Institute on Child Health and Human Development Grant 5RO1 HD072695 (PI: Santelli), National Institute of Allergy and Infection Diseases Grant R01AI114438 (PI: Wawer), and National Institutes of Health Coordinating Office of Global Health award 5U2GGH000817 (PI: Serwadda). Publisher Copyright: © 2020, Springer Science+Business Media, LLC, part of Springer Nature.

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N2 - Transactional sex (TS) is prevalent in sub-Saharan Africa. Women’s engagement in TS is linked with HIV infection; little is known about the relationship between TS, intimate partner violence (IPV) and alcohol use—established HIV risk behaviors. Using modified Poisson regression, we assessed associations between TS and physical, verbal and sexual IPV among 8248 women (15–49 years) who participated in the Rakai Community Cohort Study across forty communities in Uganda. An interaction term assessed moderation between alcohol use and TS and no significant interaction effects were found. In adjusted analysis, alcohol use and TS were significantly associated with all forms of IPV. In stratified analysis, TS was only associated with IPV in agrarian communities; alcohol use was not associated with physical IPV in trade communities or sexual IPV in trade and fishing communities. Identifying differences in IPV risk factors by community type is critical for the development of tailored interventions.

AB - Transactional sex (TS) is prevalent in sub-Saharan Africa. Women’s engagement in TS is linked with HIV infection; little is known about the relationship between TS, intimate partner violence (IPV) and alcohol use—established HIV risk behaviors. Using modified Poisson regression, we assessed associations between TS and physical, verbal and sexual IPV among 8248 women (15–49 years) who participated in the Rakai Community Cohort Study across forty communities in Uganda. An interaction term assessed moderation between alcohol use and TS and no significant interaction effects were found. In adjusted analysis, alcohol use and TS were significantly associated with all forms of IPV. In stratified analysis, TS was only associated with IPV in agrarian communities; alcohol use was not associated with physical IPV in trade communities or sexual IPV in trade and fishing communities. Identifying differences in IPV risk factors by community type is critical for the development of tailored interventions.

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Transactional Sex, Alcohol Use and Intimate Partner Violence Against Women in the Rakai Region of Uganda

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Keywords

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