Date on Master's Thesis/Doctoral Dissertation

5-2016

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Cooperating University

University of Kentucky

Department

Social Work

Degree Program

Social Work, PhD

Committee Chair

van Zyl, Adriaan Michiel

Committee Co-Chair (if applicable)

Barbee, Anita

Committee Member

Barbee, Anita

Committee Member

Sar, Bibhuti

Committee Member

Sterret-Hong, Emma

Committee Member

Soss, Marie Antoinette

Author's Keywords

HIV; South Africa; Intimate Partner Violence; Safety; Linkage to Care

Abstract

Sources warn the global HIV/AIDS epidemic will not be halted without significant reductions in Intimate partner violence (IPV). South African women have been hardest hit by the HIV-IPV link, suffering deleterious health outcomes as sequelae of significant barriers to HIV care. Extant literature focuses on HIV prevention, and there is a paucity of effective methods for mitigating IPV-related barriers among women living with HIV. This study was a Phase II trial testing the effectiveness and safety of the HIV IPV Risk and Safety (HIRS) protocol administered to women experiencing IPV and testing HIV+ during mobile HIV Counseling and Testing (HCT). Research questions compared experiences between a Standard of Care and an Experimental group with two dosage levels. All participants (N=255) were black South African females residing in Gauteng province and aged about 33 years (M=33). Two psychometric instruments were created for this study: the Danger Indicator and the HIRS scale with the latter having good reliability (Cronbach alpha .882) but both needing refinement in validity. The protocol was shown to be effective in mitigating violence upon partner notification of serostatus (X2(1) = 7.83, p=.005) and promoting linkage to care, with participants aged 33-43 years trending towards significant (X2(1) = 3.57, p=.059). The protocol was found to be feasible to implement, having impressive retention, brevity in administration, and high usage of safety strategies with minimal risks resulting from participation. Satisfaction was confirmed through positive participant ratings and safety through both non-significant group differences on the HIRS scale (t(1, 237)= -1.09; p= .278) and the perceived benefits of study participation far outweighing harms. Women receiving the protocol displayed notable self-determination towards self-protection and suffered significantly less re-assault upon partner notification. The number of participants utilizing certain safety strategies suggests this brief intervention was effective in galvanizing South African women to reclaim power and act towards the betterment of their health. Findings herald the promise of a protocol that effectively mitigates IPV to improve HIV outcomes. The effectiveness of the HIRS protocol, in facilitating safe partner notification of serostatus, could be a significant contribution to the knowledge base, but more research is needed to confirm these results.

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