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Violence Against Women and HIV/AIDS Prevention: Update from CDC’s Division of HIV/AIDS Prevention. Linda J. Koenig, PhD, MS Senior Scientist, Prevention Research Branch Division of HIV/AIDS Prevention. HIV & Violence Against Women: A National Conference August 22, 2009; Atlanta, GA.
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Violence Against Women and HIV/AIDS Prevention: Update from CDC’s Division of HIV/AIDS Prevention Linda J. Koenig, PhD, MS Senior Scientist, Prevention Research Branch Division of HIV/AIDS Prevention HIV & Violence Against Women: A National Conference August 22, 2009;Atlanta, GA
Early activities: Collaboration and agenda setting • 1998-99: DHAP co-sponsored 2 meetings to bring attention to role of abuse/violence in HIV risk and prevention • “Childhood Sexual Abuse and HIV Risk: Breaking the Link”, November, 1998, Atlanta, GA (CDC/NIMH) • CSA as risk for HIV • www.apa.org/books • “National Conference on Violence and Reproductive Health: Science, Prevention & Action”, June 1999, Atlanta, GA (CDC cross-CIO collaboration) • For HIV, co-occurring epidemics with interrelationships • MCHJ, vol 4[2] June 2000 • Outgrowth: raise awareness about need to bring disparate fields/services together
Developing the science base • Documenting the high prevalence of adult violence and childhood abuse among women with or at high risk for HIV infection, and the impact of violence/abuse on safe sex practices • Henny KD, Kidder D, Stall R, Wolitski RJ. (2007). Physical and sexual abuse among homeless and unstably housed adults living with HIV: Prevalence and associated risks. AIDS and Behavior, 11, 842-853. • Koenig, LJ, Whitaker, DJ, Royce, R, et al. (2006). Physical and sexual violence during pregnancy and after delivery: A prospective multistate study of women with or at risk for HIV infection.American Journal of Public Health, 96, 1052-1059. • Hamburger, ME, Moore, J, Koenig, LJ, et al. (2004). Persistence of inconsistent condom use: Relation to abuse history and HIV serostatus. AIDS and Behavior, 8, 333-344 • Koenig, LJand Clark, H(2004). Sexual abuse of girls and HIV infection among women: Are they related? In Koenig, LJ, Doll, L, O’Leary, A, and Pequegnat, W. (Eds.) From Child Sexual Abuse to Adult Sexual Risk: Trauma, Revictimization, and Intervention. American Psychological Association Books: Washington, DC. • Saul J, Moore J, Murphy ST, Miller LC (2004). Relationship violence and women’s reactions to male- and female-controlled HIV prevention methods. AIDS and Behavior, 8, 207-214 • Koenig, LJ, Whitaker, D., Royce, R., et al. (2002) Violence during pregnancy among women with or at risk for HIV infection. American Journal of Public Health, 92: 367-370 • Koenig, LJ, and Moore, J (2000). Women, Violence, and HIV: A Critical Evaluation with Implications for HIV Services.Maternal and Child Health Journal, 4 , 103-109. • Vlahav D, Wientge D, Moore J, et al. (1998). Violence among women with or at risk for HIV infection. AIDS and Behavior, 2:53-60.
Incorporating awareness into public health practice and HIV prevention programs • Incorporated into partner services guidance (formerly PCRS) CDC. Recommendations for partner services programs for HIV and other sexually transmitted diseases. Morbidity and Mortality Weekly Report, 2008; 57(RR9):1-63. • Diffusion of Effective Behavioral Interventions (DEBI): 2 include promotion of violence screening, recognition and referral • Future is Ours (FIO): group-intervention for women; promotes abuse awareness; http://www.cdc.gov/hiv/topics/research/prs/resources/factsheets/FIO.htm • Project Connect : Couple’s based intervention promotes violence screening & referral http://www.effectiveinterventions.org/go/interventions/connect • Gender Toolkit (CBB with OWH) • Modeled after PEPFAR/international approach for domestic audience • promotes a gendered framework for HIV prevention, include role of gender-based violence
Current activities: HIV prevention for racial and ethnic minority women • Program review: • Integrated services for Asian immigrant and refugee communities • Leung M and Koenig LJ. Integrated HIV and violence prevention:Promising programs for Asian immigrant and refugee communities.Tuesday, 3:30-5:00, A707 Mariott Marquis • Survey Research: Understanding determinants of risk for African-American and Hispanic women in the southeastern United States • Intervention: Microenterprise: promoting HIV prevention by addressing poverty • Shown in Africa to reduce both HIV and violence victimization • Current focus: poor African-American women in the southeastern U.S. • March 2006: CDC consultation Stratford D, Mizuno Y, Williams K et al. (2008) Addressing poverty as a risk for disease: Recommendations from CDC’s consultation on microenteprise as HIV prevention. Public Health Reports, 123, 9-20. • Currently developing intervention in collaboration with STD, DVP and others
Thank you. For further information, contact LKoenig@cdc.govThe findings and conclusions in this presentation are those of the author and don’t necessarily represent those of the Centers for Disease Control and Prevention