Prevalence and incidence of physical and sexual intimate partner violence perpetration among adolescent boys living with and without HIV

Background: Intimate partner violence (IPV) and HIV incidence rise substantially during adolescence. While surveys from African countries suggest that adult men living with HIV were more likely to be perpetrators of IPV, less is known about boys living with perinatal HIV (PHIV). Objectives: To measure the prevalence and incidence of IPV perpetration between adolescents who acquired HIV perinatally and their HIV-negative peers. Method: Adolescents 15–19 years old, in a sexual or dating relationship, were followed up for 1 year in Soweto, South Africa. We examined prevalence of IPV perpetration using a baseline survey and incidence using weekly prospective mobile phone surveys. Data were collected on emotional, physical, and sexual IPV. Associations between HIV status and IPV were estimated using logistic regression for lifetime and past-year perpetration, and generalised linear mixed models for past 24-h perpetration. Results: Of 498 participants, 251 were living with PHIV, and 247 were HIV-negative at baseline. Lifetime and past-year IPV perpetration were reported by 52% (PHIV 50%, HIV negative 53%) and 34% (PHIV 31%, HIV negative 37%), respectively. Over 12 000 weekly mobile surveys were submitted during follow-up. Participants reported 134 incidences of physical or sexual IPV out of 5032 occasions where the mobile survey coincided with participants seeing a partner. IPV incidence was estimated as three out of every hundred person-days. There was no significant difference in the incidence of perpetration by HIV status. Conclusion: In 3 out of 100 encounters with a partner, physical or sexual IPV perpetration was reported. Boys living with HIV were equally likely to perpetrate violence as HIV-negative boys. Interventions targeted at boys to reduce IPV behaviour should include all adolescents. In boys living with HIV who have regular contact with healthcare providers, there is an opportunity for an intervention to potentially reduce onward HIV transmission