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Intimate partner physical and sexual violence are associated with perceived and actual HIV risk among hospital outpatients in rural Uganda Susan M. Kiene, PhD Rhoda Wanyenze, Moses Bateganya, Haruna Lule, Harriet Nantaba, Michael Stein The Salawo Research Collaboration The Warren Alpert Medical School of Brown University, USA Makerere University School of Public Health, Uganda University of Washington, USA Gombe Hospital, Uganda

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Background HIV and intimate partner violence (IPV) are intertwined epidemics in many parts of the world Violence is a risk factor for HIV In Uganda, where HIV prevalence is 6.5% (UNAIDS, 2010), 48% of women and 20% of men report IPV, ever (DHS, 2006)

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Objectives Understand the prevalence of the experience of IPV among both women and men in an outpatient population in rural Uganda Explore the mechanisms by which IPV may increase risk for HIV infection Lack of access to testing Increased risk from unprotected sex

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Setting Outpatient clinic in a 100 bed comprehensive public hospital in rural Butambala District, Uganda Hospital serves a population > 300,000 Provider-initiated routine HIV-counseling and testing (PITC) offered to all outpatients regardless of presenting symptoms Free care and antiretroviral treatment

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Procedures and Measures Procedures Interviewed before receiving provider-initiated HIV- counseling and testing Measures prior HIV testing perceived likelihood of testing HIV positive history of physical (e.g., hitting, slapping) and sexual (forced sex) violence and emotional abuse (belittling, threats of violence) with current partner sexual risk behavior

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Participants 160 (82 female, 78 male) outpatients receiving provider-initiated routine HIV- counseling and testing 87% married age M=34.0 (range 20-59)

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Results Prevalence of Violence/Abuse

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Emotional Abuse: Perceived % chance they would test HIV positive Difference: Women: 2 19.14, p