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Cited by 22Intimate Partner and Family ViolenceHIV/AIDS Research and InterventionsSexual Assault and Victimization Studies

Relationship power and sexual violence among HIV-positive women in rural Uganda

Open access
Conroy, Amy A., Tsai, Alexander C., Clark, Gina M., Boum, Yap, Hatcher, Abigail M., Kawuma, Annet, Hunt, Peter W., Martin, Jeffrey N. +2 more·2016·AIDS and Behavior
DOI 10.1007/s10461-016-1385-yPMC PMC4996683
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Abstract

Gender-based power imbalances place women at significant risk for sexual violence, however, little research has examined this association among women living with HIV/AIDS. We performed a cross-sectional analysis of relationship power and sexual violence among HIV-positive women on anti-retroviral therapy in rural Uganda. Relationship power was measured using the Sexual Relationship Power Scale (SRPS), a validated measure consisting of two subscales: relationship control (RC) and decision-making dominance. We used multivariable logistic regression to test for associations between the SRPS and two dependent variables: recent forced sex and transactional sex. Higher relationship power (full SRPS) was associated with reduced odds of forced sex (AOR = 0.24; 95 % CI 0.07–0.80; p = 0.020). The association between higher relationship power and transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18–1.22; p = 0.119). Higher RC was associated with reduced odds of both forced sex (AOR = 0.18; 95 % CI 0.06–0.59; p < 0.01) and transactional sex (AOR = 0.38; 95 % CI 0.15–0.99; p = 0.048). Violence prevention interventions with HIV-positive women should consider approaches that increase women’s power in their relationships.

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Crossref · 10.1007/s10461-016-1385-y

Cites

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Statistics

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Claims the paper makes

0 of 63 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In bivariate analysis, higher full SRPS relationship power was associated with lower odds of recent forced sex (OR=0.25; 95% CI 0.08-0.78; p=0.017).

    “In the bivariate analysis, higher sexual relationship power (full SRPS) was associated with reduced odds of recent forced sex (OR = 0.25; 95 % CI 0.08–0.78; p = 0.017; Table 2)”
    Quote in the paperSubstantial claim
  • Findingown data

    After covariate adjustment, higher full SRPS relationship power remained associated with lower odds of recent forced sex (AOR=0.24; 95% CI 0.07-0.80; p=0.020).

    “After controlling for covariates in the multivariable regression models, the association between relationship power and recent forced sex remained statistically significant (AOR = 0.24; 95 % CI 0.07–0.80; p = 0.020; Table 2).”
    • Also stated in: § Abstract · plain
      “Higher relationship power (full SRPS) was associated with reduced odds of forced sex (AOR = 0.24; 95 % CI 0.07–0.80; p = 0.020).”
    Quote in the paperSubstantial claim
  • Findingown data

    In adjusted analyses, married women had higher odds of recent forced sex than unmarried women (AOR=3.78; 95% CI 1.04-13.72; p=0.043).

    “The adjusted analyses also showed that the odds of recent forced sex were higher for married versus unmarried women (AOR = 3.78; 95 % CI 1.04–13.72; p = 0.043; Table 2)”
    Quote in the paperSubstantial claim
  • Findingown data

    In bivariate analysis, higher full SRPS relationship power was associated with lower odds of recent transactional sex (OR=0.36; 95% CI 0.15-0.88; p=0.025).

    “and reduced odds of recent transactional sex (OR = 0.36; 95 % CI 0.15–0.88; p = 0.025; Table 3).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The four items used to measure transactional sex validly capture transactional sex among HIV-positive women in rural Uganda.
  • Findingown data

    In multivariable models, higher RC was associated with lower odds of transactional sex (AOR=0.38; 95% CI 0.15-0.99; p=0.048).

    “and reduced odds of transactional sex (AOR = 0.38; 95 % CI 0.15–0.99; p = 0.048; Table 3)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The four items used to measure transactional sex validly capture transactional sex among HIV-positive women in rural Uganda.
  • May combine two claims. 20
  • Classified as probably not a substantial claim. 16

  • May combine two claims.

    Findingown data

    After covariate adjustment, higher full SRPS relationship power was associated with lower odds of recent transactional sex, but the association was not statistically significant (AOR=0.47; 95% CI 0.18-1.22; p=0.119).

    “In adjusted analyses, the association with recent transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18–1.22; p = 0.119; Table 3).”
    • Also stated in: § Abstract · boosted
      “The association between higher relationship power and transactional sex was strong and in the expected direction, but not statistically significant (AOR = 0.47; 95 % CI 0.18–1.22; p = 0.119).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The four items used to measure transactional sex validly capture transactional sex among HIV-positive women in rural Uganda.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Economic transfers from men to women have been associated with unprotected sex and with HIV seropositivity.

    “These economic transfers from men to women have been linked to unprotected sex [10, 19, 20] and HIV seropositivity [21].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [10] Luke N, Kurz KM. Cross-generational and transactional sexual relations in sub-Saharan Africa: prevalence of behavior and implications for negotiating safer sexual practices. Research Paper Series. Washington, D.C.: International Center for Research on Women, Population Services International; 2002.

      Not checked in the free run.

    • cites [19] Luke N, Goldberg R, Mberu BU, Zulu EM. Social exchange and sexual behavior in young women’s premarital relationships in Kenya. J Marriage Fam. 2011;73(5):1048–64. source

      Not checked in the free run.

    • cites [20] Luke N. Economic status, informal exchange, and sexual risk in Kisumu, Kenya. Econ Dev Cult Change. 2008;56(2):375. source

      Not checked in the free run.

    • cites [21] Dunkle KL, Jewkes RK, Brown HC, et al. Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004;59:1581–92. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    In Uganda, women report that receiving money and gifts functions as sexual coercion, reducing their ability to negotiate safer sex and letting male partners set the terms of sex.

    “In Uganda, for example, women describe the receipt of money and gifts as a form of sexual coercion which constrains their ability to negotiate safer sex, thus allowing male partners to dictate the terms of the sexual encounter [9].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Wagman J, Baumgartner JN, Geary CW, et al. Experiences of sexual coercion among adolescent women: qualitative findings from Rakai District, Uganda. J Interpers Violence. 2008;24(12):2073–95. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among women living with HIV, experiencing violence is linked to worse HIV-related health, including higher risks of virologic failure, lower CD4+ counts, and death.

    “Among HIV-positive women, violence is related to declines in HIV-related health including greater risk of virologic failure [4], lower CD4+ T-lymphocyte cell counts [5], and greater risk of mortality [6].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [4] Hatcher AM, Smout EM, Turan JM, Christofides N, Stocki H. Intimate partner violence and engagement in HIV care and treatment among women: a systematic review and meta-analysis. AIDS. 2015;29(16):2183–94. source

      Not checked in the free run.

    • cites [5] Schafer KR, Brant J, Gupta S, et al. Intimate partner violence: a predictor of worse HIV outcomes and engagement in care. AIDS Patient Care STDS. 2012;26(6):356–65. source

      Not checked in the free run.

    • cites [6] Weber K, Cole A, Anastos K, et al. The effect of gender based violence (GBV) on mortality: a longitudinal study of US women with and at risk for HIV. Paper presented at the international AIDS conference, Washington, DC, 2012.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A qualitative study in Uganda found that HIV-positive women felt forced to engage in transactional sex to obtain food for themselves and their children.

    “Indeed, a qualitative study on food insecurity in Uganda showed that HIV-positive women felt compelled to engage in transactional sex with men to provide food for themselves and their children [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] Miller CL, Bangsberg DR, Tuller DM, et al. Food insecurity and sexual risk in an HIV endemic community in Uganda. AIDS Behav. 2011;15:1512–9. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The theory of gender and power holds that labor, power, and social norms interact to produce risk factors for and exposures to sexual violence.

    “According to the theory of gender and power, three social structures of labor, power, and social norms interact to create risk factors for and exposures to sexual violence [24, 25].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [24] Connell RW. Gender and power. Stanford: Stanford University Press; 1987.

      Not checked in the free run.

    • cites [25] Wingood GM, DiClemente RJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Educ Behav. 2000;27:539–65. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The theory of gender and power suggests that women in poverty may be coerced into sex because of competing survival needs.

    “Similarly, regarding transactional sex, the theory proposes that women living in poverty may be coerced into sex due to competing survival needs [28].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Kuate-Defo B. Young people’s relationships with sugar daddies and sugar mummies: what do we know and what do we need to know? Afr J Reprod Health. 2004;8(2):13–37. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Women with low relationship power have less control over when and how often sex occurs and less ability to negotiate safer sex.

    “Thus, women with low relationship power have limited control over the timing and frequency of sex, and negotiating power over safer sex [23, 26, 27].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [23] Blanc A. The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Stud Fam Plan. 2001;32(3):189–213. source

      Not checked in the free run.

    • cites [26] Dixon-Mueller R. The sexuality connection in reproductive health. Stud Fam Plan. 1993;24:269–82. source

      Not checked in the free run.

    • cites [27] Worth D. Sexual decision-making and AIDS: why condom promotion among vulnerable women is likely to fail. Stud Fam Plan. 1989;20(6):297–307. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Sexual Relationship Power Scale (SRPS) is a theoretically grounded, validated measure of power in sexual relationships that has been widely used in sub-Saharan Africa.

    “The SRPS is a theoretically-based and validated measure of power within a sexual relationship that has been extensively used in sub-Saharan Africa [35].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [46] Pulerwitz J, Gortmaker SL, DeJong W. Measuring relationship power in HIV/STD research. Sex Roles. 2000;42(7/8):637–60. source

      Not checked in the free run.

    • cites [35] McMahon JM, Volpe EM, Klostermann K, Trabold N, Xue Y. A systematic review of the psychometric properties of the sexual relationship power scale in HIV/AIDS research. Arch Sex Behav. 2015;44(2):267–94. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Missing data were below 6.5% for every variable and below 2% for most variables.

    “Missing data were less than 6.5 % on any given variable (less than 2 % for most variables).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    HIV-positive women experience higher rates of violence and poverty than HIV-negative women.

    “who have higher rates of violence and poverty than their HIV-negative counterparts [36–38]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [36] van der Straten A, King R, Grinstead OA, et al. Sexual coercion, physical violence, and HIV infection among women in steady relationships in Kigali, Rwanda. AIDS Behav. 1998;2:61–73. source

      Not checked in the free run.

    • cites [37] Maman S, Mbwambo JK, Hogan NM, et al. HIV-positive women report more life-time partner violence: findings from a voluntary counselling and testing clinic in Dar es Salaam, Tanzania. Am J Public Health. 2002;92:1331–7. source

      Not checked in the free run.

    • cites [38] Farmer P, Simmons J, Conners M. Women, poverty, and AIDS: sex, drugs, and structural violence. Monroe: Common Courage Press; 1996.

      Not checked in the free run.

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    Premisecitation

    HIV-positive women are highly vulnerable to stigma, discrimination, and poor physical and mental health because of their HIV status.

    “and are highly susceptible to stigma, discrimination, and poor physical and mental health as a consequence of their HIV status [39–41]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [39] Simbayi LC, Kalichman SC, Strebel A, et al. Internalised stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town, South Africa. Soc Sci Med. 2007;64:1823–31. source

      Not checked in the free run.

    • cites [40] Hatcher AM, Tsai AC, Kumbakumba E, et al. Sexual relationship power and depression among HIV-infected women in rural Uganda. PLoS One. 2012;7(12):1–7. source

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    • cites [41] Siedner MJ, Tsai AC, Dworkin S, et al. Sexual relationship power and malnutrition among HIV-positive women in rural Uganda. AIDS Behav. 2012;16:1542–8. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Of 325 eligible women, 307 completed the baseline SRPS survey, a 95% completion rate.

    “Among the 325 eligible women, 307 completed the baseline SRPS survey (95 %).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Other Ugandan research has found that food-insecure HIV-positive women use transactional sex as a survival strategy and that men knowingly consider this when approaching them for sex.

    “Other research from Uganda has found that for HIV-positive women who are food insecure, transactional sex is an important strategy for survival and one that men knowingly consider when they approach women for sex [14, 29].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Bene C, Merten S. Women and fish-for-sex: transactional sex, HIV/AIDS and gender in African fisheries. World Dev. 2008;36(5):875–99. source

      Not checked in the free run.

    • cites [29] Miller CL, Bangsberg DR, Tuller DM, et al. Food insecurity and sexual risk in an HIV endemic community in Uganda. AIDS Behav. 2011;15:1512–9. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    The finding that RC correlates more strongly with sexual violence than DMD is consistent with a Ugandan study of malnutrition among HIV-positive women and with research framing sexual violence as men's attempt to control female partners.

    “We also found that RC (i.e., relationship control) was more strongly correlated with sexual violence than DMD (i.e., decision-making dominance), which is consistent with a study of malnutrition among HIV-positive women from Uganda [41] and other research describing sexual violence as an attempt by men to maintain control over female partners (e.g., [22, 58, 59]).”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [41] Siedner MJ, Tsai AC, Dworkin S, et al. Sexual relationship power and malnutrition among HIV-positive women in rural Uganda. AIDS Behav. 2012;16:1542–8. source

      Not checked in the free run.

    • cites [22] Jewkes R. Intimate partner violence: causes and prevention. Lancet. 2002;359:1423–9. source

      Not checked in the free run.

    • cites [58] Frieze IH. Investigating the causes and consequences of marital rape. Signs. 1983;8:532–53. source

      Not checked in the free run.

    • cites [59] Gage AJ, Hutchinson PL. Power, control, and intimate partner violence in Haiti. Arch Sex Behav. 2006;35:11–24. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Across sub-Saharan Africa, alcohol use has been linked to rape, sexual coercion, and transactional sex, and it is common among HIV-positive individuals.

    “Across sub-Saharan Africa, alcohol use has been linked to rape, sexual coercion, transactional sex [15, 21, 47, 60–63], and frequently occurs among HIV-positive individuals [62, 64].”
    Quote in the paperNot a substantial claim0 of 8 sources checked
    • cites [15] Dunkle KL, Jewkes R, Nduna M, et al. Transactional sex with causal and main partners among young South African men in the rural Eastern Cape: prevalence, predictors, and associations with gender-based violence. Soc Sci Med. 2007;65:1235–48. source

      Not checked in the free run.

    • cites [21] Dunkle KL, Jewkes RK, Brown HC, et al. Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004;59:1581–92. source

      Not checked in the free run.

    • cites [47] Zablotska IB, Gray RH, Koenig MA, et al. Alcohol use, intimate partner violence, sexual coercion and HIV among women aged 15–24 in Rakai, Uganda. AIDS Behav. 2009;13:225–33. source

      Not checked in the free run.

    • cites [60] Jewkes R, Levin J, Penn-Kekana L. Risk factors for domestic violence: findings from a South African cross-sectional study. Soc Sci Med. 2002;55:1603–17. source

      Not checked in the free run.

    • cites [61] Jewkes R, Dunkle K, Koss MP, et al. Rape perpetration by young, rural South African men: prevalence, patterns and risk factors. Soc Sci Med. 2006;63:2949–61. source

      Not checked in the free run.

    • cites [62] Kalichman SC, Simbayi LC, Kaufman M, Cain D, Jooste S. Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: systematic review of empirical findings. Prev Sci. 2007;8:141–51. source

      Not checked in the free run.

    • cites [63] Shannon K, Leiter K, Phaladze N, et al. Gender inequity norms are associated with increased male-perpetrated rape and sexual risks for HIV infection in Botswana and Swaziland. PLoS One. 2012;7(1):1–8. source

      Not checked in the free run.

    • cites [64] Zablotska IB, Gray RH, Serwadda D, et al. Alcohol use before sex and HIV acquisition: a longitudinal study in Rakai, Uganda. AIDS. 2006;20(8):1191–6. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Women's alcohol consumption may increase the chance that a dispute becomes violent and may impair judgment and recognition of early violence cues.

    “Women’s consumption of alcohol may enhance the likelihood that a dispute will lead to violence and can also have a disinhibiting effect by clouding judgment and the ability to recognize early cues of violence.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Being married was positively associated with forced sex, consistent with research on social norms that wives owe sex to husbands.

    “Finally, we found that being married was positively associated with forced sex, which is consistent with research on social norms around women’s duty to have sex with their husbands [9, 66].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [9] Wagman J, Baumgartner JN, Geary CW, et al. Experiences of sexual coercion among adolescent women: qualitative findings from Rakai District, Uganda. J Interpers Violence. 2008;24(12):2073–95. source

      Not checked in the free run.

    • cites [66] Jewkes R, Abrahams N. The epidemiology of rape and sexual coercion in South Africa: an overview. Soc Sci Med. 2002;55:1231–44. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A systematic review found that the RC subscale has sound psychometric properties across many studies, while the DMD subscale is weaker and more sensitive to population and setting.

    “A systematic review found that the RC subscale exhibited sound psychometric properties across many studies whereas the DMD subscale was weaker and more sensitive to specific populations and settings [35].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [35] McMahon JM, Volpe EM, Klostermann K, Trabold N, Xue Y. A systematic review of the psychometric properties of the sexual relationship power scale in HIV/AIDS research. Arch Sex Behav. 2015;44(2):267–94. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A South African study found that among women who met partners in bars, nearly half reported that their partner bought them drinks in exchange for sex.

    “A study in South Africa showed that among women who met their partners in bars, nearly half reported that their partner bought them drinks for sex [21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Dunkle KL, Jewkes RK, Brown HC, et al. Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection. Soc Sci Med. 2004;59:1581–92. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Stigma, discrimination, and similar disempowering experiences generally lower adherence to ART and weaken retention in care.

    “It is well established that stigma, discrimination, and other disempowering experiences tend to reduce ART adherence and undermine retention in care [68, 69].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [68] Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review. AIDS. 2012;26(16):2059–67. source

      Not checked in the free run.

    • cites [69] Katz IT, Ryu AE, Onuegbu AG, et al. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. J Int AIDS Soc. 2013;16(3 Suppl 2):18640. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    HIV-positive women experience a higher concentration of violence, poverty, and other social disadvantages.

    “While violence, poverty, and other forms of social disadvantage are more concentrated within HIV-positive women [36–38]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [36] van der Straten A, King R, Grinstead OA, et al. Sexual coercion, physical violence, and HIV infection among women in steady relationships in Kigali, Rwanda. AIDS Behav. 1998;2:61–73. source

      Not checked in the free run.

    • cites [37] Maman S, Mbwambo JK, Hogan NM, et al. HIV-positive women report more life-time partner violence: findings from a voluntary counselling and testing clinic in Dar es Salaam, Tanzania. Am J Public Health. 2002;92:1331–7. source

      Not checked in the free run.

    • cites [38] Farmer P, Simmons J, Conners M. Women, poverty, and AIDS: sex, drugs, and structural violence. Monroe: Common Courage Press; 1996.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Evidence from other settings suggests that both directions of the IPV-HIV association may be possible.

    “Evidence from other settings suggests that both directions may be possible [67].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Hatcher AM, Woollett N, Pallitto CC, et al. Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission. J Int AIDS Soc. 2014;17:19233. source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Because there were few events, leading to wide confidence intervals for several covariates, the study cannot exclude either small or large effect sizes.

    “Fourth, we would like to highlight that due to a low number of events, which resulted in large confidence intervals for several covariates, we cannot rule out relatively small or large effect sizes.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Using interviewers matched by gender in face-to-face interviews, along with ethical procedures, might have reduced the underreporting bias.

    “although the use of gender-matched, face-to-face interviewers and ethical procedures may have minimized this bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Policy-makers have advocated for anti-violence programs integrated into health services like HIV testing and counseling.

    “At the structural level, policy-makers have called for anti-violence programs that are integrated within healthcare services such as HIV testing and counseling [71].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] WHO. 16 Ideas for addressing violence against women in the context of the HIV epidemic: a programming tool. Geneva: World Health Organization; 2013.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Violence interventions for women living with HIV/AIDS are still needed.

    “There remains a tremendous unmet need for violence interventions targeting women living with HIV/AIDS.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Only a small number of interventions have been created for HIV-positive women.

  • May combine two claims.

    Study design and conductown data

    The estimate for the relationship power-transactional sex association is probably underpowered and imprecise because of the small number of sexual violence events in this small sample.

    “while this trend was strong and in the expected direction, the estimate is likely to be underpowered and imprecise due to the few events of sexual violence in this small sample.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Violence is fundamentally a process involving two people.

    “as violence is inherently a dyadic process [79].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [79] Conroy AA. Marital infidelity and intimate partner violence in rural Malawi: a dyadic investigation. Arch Sex Behav. 2014;43(7):1303–14. source

      Not checked in the free run.

29 of 29

  • The paper relies on this without support.

    The four items used to measure transactional sex validly capture transactional sex among HIV-positive women in rural Uganda.

    “Transactional sex was a binary variable captured with four items that asked respondents about whether they had sex in exchange for food, cash/consumer goods, a place to stay, or a job.”

  • The paper relies on this without support.

    The study is among the first to investigate relationship power and sexual violence in HIV-positive women in Africa.

    “This study is one of the first to examine relationship power and sexual violence among HIV-positive women in Africa.”

  • The paper relies on this without support.

    Only a small number of interventions have been created for HIV-positive women.

    “few interventions have been developed for this population.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Power imbalances within relationships and men's beliefs about gender roles are thought to be risk factors for violence against women.

    “To take a specific example: power imbalances within relationships30, 31 and men’s beliefs about gender roles32 are thought to be risk factors for cases of violence against women.”

    From Co-occurring epidemics, syndemics, and population health (2017) · cites this paper as [30]

Cites

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1 of the 80 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Weber K, Cole A, Anastos K, et al. The effect of gender based violence (GBV) on mortality: a longitudinal study of US women with and at risk for HIV. Paper presented at the international AIDS conference, Washington, DC, 2012.

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Authors
Conroy, A. A., Tsai, A. C., Clark, G. M., Boum, Y., Hatcher, A. M., Kawuma, A., Hunt, P. W., Martin, J. N., Bangsberg, D. R., & Weiser, S. D.
Affiliations
  • University of California, San Francisco (US)
  • Massachusetts General Hospital (US)
  • Kaiser Permanente (US)
  • Mbarara University of Science and Technology (UG)
  • Harvard University (US)
Corresponding author
Conroy, Amy A.
ORCID
Venue
AIDS and Behavior
Publisher
Springer Science and Business Media LLC
Published
2016-04-06
Volume
20
Issue
9
Pages
2045-2053
ISSN
  • 1090-7165 (ISSN-L)
  • 1573-3254
DOI
10.1007/s10461-016-1385-y
PMC
PMC4996683
OpenAlex
W2319264162
Semantic Scholar
a829b8ac7e5b42854d59b8337609631b4bc8c164
Cited by
22
References
80
Citations by year
2025: 1 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 6
FWCI
4.40
Type
journal article
Language
en
Open access
Licence
Locations
  • AIDS and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute of Mental Health (K23 MH-079713, K23 79713-03S1, R01 MH-54907, K24 MH-87227, K23 MH-096620, T32 MH-019105)
  • National Institutes of Health (P30 AI27763)
  • Tim and Jane Meyer Family Foundation
  • Burke Family Foundation
Topics
  • Social Sciences › Health › Intimate Partner and Family Violence
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
Keywords
power in relationships, sexual violence, women living with HIV, forced sex, transactional sex, relationship control, antiretroviral therapy, violence prevention interventions, rural Uganda
MeSH terms
Adult, Cross-Sectional Studies, Female, HIV Seropositivity, Humans, Male, Power, Psychological, Risk Factors, Rural Population, Sexual Behavior, Sex Offenses, Uganda, HIV Infections, Logistic Models, Anti-Retroviral Agents, Young Adult, Social Stigma

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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