Types and risk factors of violence experienced by people living with HIV, Pakistan: a cross-sectional study

Background: In Pakistan, data are lacking on the violence experienced by people living with HIV. Aims: This study determined the prevalence and risk factors of violence (physical, psychological and sexual) in people living with HIV in Karachi, Pakistan. Methods: This was a cross-sectional study in 2016 of people living with HIV attending clinics of Bridge Consultants Foundation, a community-based care provider. Date were collected using an interview-based questionnaire. Multivariate logistic regression analysis was done to assess the risk factors for violence with adjusted odds ratios (aOR) and 95% confidence intervals (CI) presented. Results: The sample included 250 people living with HIV; 183 were men, 60 were women and 7 were transgender. The mean (standard deviation) age of the participants was 30 (6.5) years. The prevalence rates of psychological, sexual and physical violence were 79.6%, 74.8% and 64.4%, respectively. More women experienced physical violence than men (76.2% versus 60.7%). Psychological violence was associated with injecting drug use (aOR = 2.64, 95% CI: 1.27-5.50) and being married (aOR = 0.46, 95% CI: 0.24-0.90). Marriage (aOR = 2.30, 95% CI: 1.27-4.16) and having an HIV-positive partner (aOR = 2.07, 95% CI: 1.09-3.92) were risk factors for sexual violence. Physical violence was associated with young age (aOR = 0.95; 95% CI: 0.91-0.99) and having an HIV-positive partner (aOR = 2.17, 95% CI: 1.10-4.26). Conclusion: Violence is an important public health problem affecting people living with HIV in Pakistan. This issue needs to be addressed by the government and nongovernmental organizations.