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January 22, 2003

Domestic Violence Levels High in Rural Uganda

Linked to Alcohol Consumption and Perceived Risk of HIV

Male to female domestic violence levels in rural Uganda are high and associated with both alcohol consumption and the male partner’s perceived risk of HIV, according to a study conducted by researchers from the Johns Hopkins Bloomberg School of Public Health. The study found that approximately one in three women living in rural Uganda reported being physically threatened or assaulted by her current partner. The findings from the study suggest possible links between the risk of domestic violence and alcohol consumption and women’s perceived risk of HIV of their male partner. The study is published in the January 22, 2003 edition of the Bulletin of the World Health Organization and is among the first studies from Sub-Saharan Africa to examine domestic violence at a community level.

For the study, Michael A. Koenig, PhD, associate professor with the Department of Population and Family Health Sciences at the Johns Hopkins Bloomberg School of Public Health, and Ronald Gray , MD, the School’s William G. Robertson Professor of Population and Family Planning, collaborated with researchers from Columbia University and Uganda’s Rakai Project. They surveyed 5,109 women and 3,881 men living in the Rakai District of Uganda, which is at the center of the country’s AIDS epidemic. The women and men were asked detailed questions about their experiences and attitudes concerning domestic violence and sexual relationships.

Overall, the study found that 30 percent of women had experienced physical threats or abuse from their current partner and 20 percent reported experiencing violence during the year before the survey. Three of five women who reported physical threats or abuse experienced three or more specific acts of violence during the previous year. Nearly 50 percent reported receiving injuries as a result. Female to male domestic violence was less common, but also occurred. Five percent of women in the study said they had physically threatened or assaulted their male partners during the preceding year.

The findings of the study highlight the important links between domestic violence and both alcohol consumption and perceived HIV risk. Women whose partners frequently consumed alcohol had approximately four times higher risk of recent domestic violence than women whose partners did not drink. In addition, women who perceived their partner to be at high risk of HIV had almost four times greater risk of recent domestic violence, compared to women who perceived their partner to be at very low risk.

“Although further research is clearly needed, our findings provide important indirect evidence that domestic violence may represent a significant factor in increasing women’s vulnerability to HIV acquisition in settings such as Uganda,” explained Dr. Koenig. “Fear of HIV infection may lead women to avoid sex with their partner, which in turn may precipitate threats of violence or physical abuse. It is possible that current programs to prevent HIV may be overlooking domestic violence as a key behavioral dimension of HIV transmission.” 

The authors note, at the same time, widespread acceptance of domestic violence in this setting. Fully 70 percent of men, and 90 percent of women, viewed beating of the wife or female partner as justifiable in one or more circumstances. In their view, “little progress in reducing levels of domestic violence in settings such as Uganda is likely to be achieved without significant changes in prevailing individual and community attitudes toward such violence.”

“Domestic violence in rural Uganda: evidence from a community-based study” was written by Michael A. Koenig, Tom Lutalo, Feng Zhao, Fred Nalugoda, Fred Wabwire-Mangen, Noah Kiwanuka, Jennifer Wagman, David Serwadda, Maria Wawer, and Ronald Gray.

The research was funded by grants from the National Institute of Allergy and Infectious Diseases, the National Institute of Child Health and Human Development, the Rockefeller Foundation, and the World Bank Uganda Sexually Transmitted Infectious Infections Project.

Public Affairs Media Contacts for the Johns Hopkins Bloomberg School of Public Health: Kenna Brigham or Tim Parsons @ 410-955-6878 or paffairs@jhsph.edu.

Photographs of Ronald Grayare available upon request.