A mixed methods approach to investigate partner violence in HIV-positive outpatients
Individuals with HIV face a variety of long-term physical and mental health issues related to their HIV disease, including indefinite andretroviral treatment with numerous side effects, the stigma around HIV status disclosure, and high rates of anxiety and depression. Affecting up to 67% of HIV-infected outpatients in recent studies, partner violence (PV) may be a significant barrier to achieving optimal health for this population, given the overlapping risk factors for the two phenomena, including elevated rates of poverty and drug use. With high prevalence and well-documented decrements in physical and mental health as consequences in HIV-negative samples, it is possible that PV exacerbates potentially negative health outcomes in HIV-positive individuals because of their increased psychological and immunological vulnerability. The present inquiry attempts to increase understanding of the overlapping epidemics of PV and HIV through a mixed methods approach. Qualitative methods were employed to elucidate further key aspects of PV as they intersect in the lives of HIV-positive individuals receiving outpatient medical care. Results of the qualitative study informed the development and refinement of the survey study to follow, a cross-sectional study conducted on a demographically similar sample of HIV-positive outpatients. This dissertation reports the results of this inquiry in the following three chapters: (a) a comprehensive literature review of U.S.-based studies of PV among HIV-positive individuals through February January 2007; (b) a qualitative study (N=28) detailing the lived experience of HIV-positive men who have sex with men who experienced PV; and (c) a survey study measuring the prevalence of physical, sexual, and psychological PV. Further, data from the survey study were used to test a theoretical model that hypothesizes mental health as a mediator between interpersonal violence experienced and physical health and functioning.
- Psychology