HORIZONS PROJECT
HIV-associated Violence: Implications for HIV Counseling and Testing Programs in Dar es Salaam, Tanzania

Building on previous research, this study explored the links between HIV infection, serostatus disclosure, and partner violence among women attending the Muhimbili Health Information Centre (MHIC), a voluntary counseling and testing (VCT) clinic in Dar es Salaam, Tanzania.

The study first collected qualitative data from women, men, and couples (n=67) who were MHIC clients. In the second phase, researchers enrolled 340 women after pretest counseling and prior to collection of test results; 245 of these women were followed and interviewed three months after enrollment and testing. Nearly a third of the sample were HIV-positive, almost half were married, and 50 percent were between the ages of 18 and 29 years and had less than seven years of education. The study followed WHO ethical and safety protocols for conducting research on violence against women.

Key findings:

• Many women lack autonomy to make decisions about HIV testing.
• Disclosure to partners by HIV-positive women has increased over time but is still significantly less than that for HIV-negative women. 
• Partner violence is a serious problem among many female VCT clients.
• A small proportion of women who disclosed their serostatus to partners reported a negative reaction.
• Women’s HIV status is strongly associated with partner violence.

The research team made a number of recommendations that could reduce the barriers women face in getting tested for HIV and in disclosing their serostatus to their partners, as well as reduce levels of partner violence. These recommendations pertain to VCT services as well as to the wider community and policy environment.

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Location

Dar es Salaam, Tanzania

Duration

October 2000–November 2003

Horizons and Population Council researcher

Ellen Weiss

Non-Council collaborators

Suzanne Maman, Michael Sweat (Johns Hopkins University School of Public Health)

Margaret Hogan, Gad Kilonzo, Jessie Mbwambo, (Muhimbili University College of Health Sciences)

Elizabeth Chezi, Caroline Chikokoto, Peter Deogratius, Lusajo Kajula, Anna Kavugha, Cliff Mbwambo, Abassy Mlemba, Fred Mungure, Methodia Muzale, Irene Mwanga (Tuelewane Project)

DATEX

Family Health International

Muhimbili Health Information Centre

US Agency for International Development/Tanzania

Donors

US Agency for International Development

Fogarty International Center

USIS Fulbright Fellowship

Publications/Resources on this project

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Related Project

• Reducing HIV Risk Through Violence Prevention with Young Men in Tanzania

See Also

• Tanzania

• Horizons Program

• HIV and AIDS

• HIV and AIDS/Prevention

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