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Background: There is increasing evidence linking women''s experience of intimate partner violence (IPV) and enhanced risk of acquiring HIV. In a study conducted in rural communities in Uganda, the adjusted population attributable fraction of incident HIV attributable to IPV was 22.2% (95% CI 12.5-30.4). With increasing interest in addressing violence against women in the context of the HIV response, we are conducting the MAISHA study to evaluate the impact of two contrasting social and economic intervention approaches in northwest Tanzania
Methods: We are conducting trials to evaluate the incremental impact on participants'' experience of IPV of a participatory gender training curriculum for women in existing microfinance groups and for women in newly-formed groups not receiving microfinance. To date, we have enrolled 1021 women in microfinance groups and 1052 women not receiving microfinance. At baseline, ever partnered women were interviewed by trained, same sex interviewers about their lifetime and past 12-month experience of IPV, economic abuse, emotional abuse and controlling behaviour.
Results: Among women enrolled into the study, 61% (95% CI: 58-64%) of women receiving microfinance and 67% (95% CI: 64-70%) not receiving microfinance reported ever experiencing physical and/or sexual IPV with 27% (95% CI: 24-29%) and 36% (95% CI 33-39%) reporting IPV in the previous 12 months. Partner controlling behaviour was the most prevalent type of abuse - 82% of women receiving microfinance and 78% not receiving microfinance reported having experienced it in their lifetime, while 63% and 64% reported experiencing it in the previous 12 months. Other abuses were also common; more than one third (34% microfinance, 39% non-microfinance) of women reported economic abuse and a high proportion of women reported emotional abuse (39% microfinance, 56% non-microfinance) during the previous 12 months. Higher prevalence rates were observed among younger women, women with young partners, and less educated women. Intervention delivery is ongoing, with the results expected in 2018.
Conclusions: Levels of violence and abuse are very high in this study population, particularly among younger women, who are also at highest risk of HIV infection in Tanzania. These findings underline the importance of developing and testing appropriate violence prevention interventions.