Prevalence and correlates of physical, emotional, sexual, and technology-facilitated gender-based violence among a national sample of adolescent and adult women living with HIV in Zambia

The study’s objective was to assess the prevalence and correlates of physical, emotional, sexual, and technology-facilitated intimate partner violence (IPV) as well as poly-victimization among a national sample of adolescent and adult women living with HIV (WLHIV) in Zambia in 2024. Data from 1,063 WLHIV between the ages of 15 and 49 who took part in the 2024 Zambia Demographic and Health Survey and responded to the domestic violence and mental health module were examined. Logistic regressions were used to estimate predictors of physical, emotional, sexual, and technology-facilitated IPV as well as poly-victimization. More than one in four women (28.8%) had exposure to physical violence, followed by emotional violence (24.6%), sexual violence (9.4%) and technology-based violence (6.0%). Exposure to any IPV was 40.8% and 20.1% had poly-victimization (2–4 types of IPV). In adjusted logistic regression analysis being widowed, divorced, or separated were associated with physical IPV, emotional IPV, and poly-victimization. Internet use and urban residence were associated with technology-based IPV. Screened depression and/or anxiety disorders and/or on medication for depression or anxiety was associated with emotional IPV, technology-facilitated IPV, and poly-victimization. Suicidal ideation was associated with physical IPV. Being ashamed of HIV was associated with emotional IPV, sexual IPV technology-facilitated IPV, and poly-victimization. HIV disclosure was inversely associated with technology-facilitated violence. Current tobacco use was negatively and current alcohol use was positively associated with physical IPV. A supportive attitude towards wife beating was associated with sexual IPV and poly-victimization. Experiencing controlling behaviour and having a husband or partner who is often drunk were highly associated with physical IPV, emotional IPV, sexual IPV and poly-victimization. More than one in four WLHIV (28.8%) had exposure to physical violence, followed by emotional violence (24.6%), sexual violence (9.4%) and technology-based violence (6.0%). Exposure to any IPV was 40.8% and 20.1% had poly-victimization (2-4 types of IPV). In addition, the survey identified the multifaceted nature of physical, emotional, sexual, and technology-facilitated IPV, highlighting contributing individual-level, relationship-level, and community/societal-level factors. Findings underscore the need for an integrated policy response to IPV among WLHIV in Zambia.