Safeguarding women’s and girls’ wellbeing: Exploring the role of gender-based violence on HIV transmission in Zimbabwe
Abstract Background Gender-based violence (GBV) is a growing epidemic, whose role in HIV transmissions remains minimally addressed by the majority of national HIV response interventions. Methods Statistical and geo-spatial analysis was used to explore the relationship between GBV variables and HIV status using data from Zimbabwe Demographic and Health Survey, 2015-16. Results Women who were ever humiliated by their husbands or partners were 1.45 times more likely to be HIV positive than those who were never humiliated, p = 0.002. The same was true for women whose husbands or partners ever threatened to harm them or someone they love, OR (95%CI) 1.33 (1.04–1.68), p = 0.022. There was a positive association between HIV status and women who reported that their husband or partner, either pushed, shook, or threw something at them or punched them with his fist or with something that could hurt them or kicked, dragged or beat them, or tried to choke or burn them on purpose or threatened or attacked them with a knife or gun, or any other weapon. Women who experienced forced sexual violence with threats were more likely (odds 1.61, p = 0.019), to be HIV positive than those women who did not experience the same. Using geospatial mapping techniques our study has shown a substantial countrywide epidemic of GBV against women in Zimbabwe requiring urgent attention. Emotional GBV had a similar geographical distribution with HIV in the northern part of the country, where all three types of violence tend to aggregate. Conclusion There is a significant association between forms of GBV (emotional, physical, and sexual) and HIV status. The results suggest the need to strengthen interventions that empower women and girls with skills to withstand violence in order to curb HIV transmission. The engagement of men as proponents of gender equality, bringing other men to account for perpetuating GBV and actively countering violence against women and girls, is critical to the design of such interventions.