Domestic Violence Shelters as Prevention Agents for HIV/AIDS?
Rountree, Michele A., Pomeroy, Elizabeth C., Marsiglia, Flavio F., Health and Social Work
Women are at a heightened risk of experiencing two prominently positioned public health concerns: intimate partner abuse (IPA) and HIV/AIDS. Women are far more likely than men to be raped or physically assaulted by an intimate partner, with seven out of 10 women being raped or assaulted by an intimate partner, friend, or acquaintance (Bureau of Justice Statistics, 2005). Between 1976 and 2004, 51.9 percent of all female homicides were committed by intimate partners or acquaintances (Catalano, 2006). Intimate partner violence constituted 22 percent of all violent crimes against women between the years 1993 and 2004 (Catalano, 2006).
Since the first diagnosis of HIV in 1981, the number of women infected with the disease tripled from 8 percent in 1985 to 27 percent in 2004 (Centers for Disease Control and Prevention [CDC], 2007). In fact, the CDC reports that if trends continue, women will outnumber men with this disease in the near future. In addition, in 2004, an estimated 80 percent of all women with AIDS were women of color (CDC, 2007). A report by UNAIDS (2006) stated the following:
In the U.S., AIDS is the leading cause of death among African-American women ages 25 to 34, with AIDS rates among Hispanic women rapidly on the rise. Although many factors contribute to these trends, the majority of women who are HIV-infected--or at great risk--do not practice "high-risk" behavior. Women and gifts are vulnerable largely because of the behavior of others--too often lacking not just information, but the social and economic power to control their bodies and their lives. (p. 2)
Consequently, research suggests that the disproportionate rates of women contracting HIV/AIDS may be explained in part by the intersection between IPA and HIV/AIDS, whereby sexual and physical violence toward women affects the likelihood of transmission (Beadnell, Baker, Morrison, & Knox, 2000; Eby, Campbell, Sullivan, & Davidson, 1995; El-Bassel et al., 1998; Gielen, McDonnell, Burke, & O'Campo, 2000; He, McCoy, Stevens, & Stark, 1998; Liebschutz, Feinman, Sullivan, Stein, & Samet, 2000; North & Rothenberg, 1993; Wingood, DiClemente, & Raj, 2000). Women who have a history of both sexual and physical abuse by intimate partners are more than three times as likely to report having a sexually transmitted disease (STD) during the abusive relationship, 5.6 times more likely to report having multiple STDs, and 5.3 times more likely to report having an STD over the past two months. In addition, sexually and physically abused women are 2.7 times more likely to worry about acquiring HIV (Wingood et al., 2000).This research suggests that women in abusive relationships need information about how to keep themselves safe from infection.
Women who have experienced intimate partner abuse often seek refuge from domestic violence (DV) shelters. Because DV shelters are a social service entry point for women seeking a violence-free environment, several researchers (El-Bassel et al., 1998; He et al., 1998; Molina & Basinait-Smith, 1998; Wingood et al., 2000) recommended that these shelters operate as a venue for assessing a client's risk of HIV/AIDS and provide HIV/AIDS education and prevention information. The current study investigated the presence or absence of HIV/AIDS services in DV shelters within a southwestern state. What is not apparent in the literature is whether DV shelters, a primary entry point for women experiencing intimate partner abuse seeking support and services, provide HIV/AIDS services. The findings of this research study will inform structural recommendations for DV shelters inclusive of their client's heightened risk of infection. On the basis of these findings, recommendations are made to integrate risk assessment, HIV/AIDS education and prevention information into shelter policies, procedures, and the service delivery protocols.
The purpose of this pilot investigative study was to examine the provision of HIV/AIDS services in DV shelters. …