The intersection of intimate partner violence against women and HIV/AIDS: a review.

The objective of this study was to review original research on the intersection of violence against women by intimate partners and risk for HIV infection and highlight opportunities for new research and programme development. Seventy-one articles presenting original, peer-reviewed research conducted with females aged 12 years and older in heterosexual relationships during the past decade (1998-2007) were reviewed. Studies were eligible for inclusion if they addressed intimate partner violence (IPV) against women and HIV/AIDS as mutual risk factors. The prevalence of IPV and HIV infection among women varies globally, but females remain at elevated risk for both IPV and sexually transmitted/HIV infection, independently and concurrently. Comparisons between sero-negative and -positive women varied by geographic region; African HIV-positive women reported higher rates of victimisation while findings were inconsistent for HIV-positive women in the USA. Studies among various populations support the existence of a temporally and biologically complex relationship between HIV risk, lifetime exposure to violence and substance use, which are further complicated by gender and sexual decision-making norms. A possible link between violence-related post traumatic stress disorder and comorbid depression on immunity to HIV acquisition and HIV disease progression warrants further investigation. Sexual risk related to IPV works through both male and female behaviour, physiological consequences of violence and affects women across the lifespan. Further physiological and qualitative research is needed on the mechanisms of enhanced transmission; prospective studies are critical to address issues of causality and temporality. Prevention efforts should focus on the reduction of male-perpetrated IPV and male HIV risk behaviours in intimate partnerships.

Non-health professionals and the school-age child: early intervention for behavioral problems.

A methodology is described to utilize dormitory parents in direct care activities for the early intervention of behavioral problems of the school-age child. Specific information gathering, assessment, treatment, referral and follow-up tasks were defined and incorporated into a problem-solving protocol which served to guide the dormitory parents through the defined problem-solving process, to promote early identification of students with a behavioral problem, and to expedite referral to a professional for students with more severe problems. The methodology was pilot-tested in a large American Indian boarding school and demonstrated the feasibility and efficacy of dormitory parents in a therapeutic role as one component of a team approach to the management of behavioral problems. The pilot study resulted in a significant reduction in the rates of alcohol abuse and school dropouts and deserves application in a variety of settings.