Physical and sexual violence during pregnancy and after delivery: A prospective multistate study of women with or at risk for HIV infection

Objectives. We sought to describe and compare prevalence rates of and risk factors for violence against women during pregnancy and postpartum. Methods. Physical and sexual violence and violence risk factors were assessed during late pregnancy and 6 months postpartum in a prospective study of pregnant women with (n = 336) and without (n = 298) HIV in 4 US states. Results. Overall, 10.6% of women reported having experienced violence, 8.9% during pregnancy and 4.9% after delivery. Of these women, 61.7% were abused only during their pregnancy, 21.7% were repeatedly abused, and 16.7% were abused only after their delivery. Sexual violence rarely occurred in the absence of physical violence. The strongest predictor of violence was engaging in bartered sex (adjusted odds ratio [OR] = 5.54; 95% confidence interval [CI] = 2.0, 15.4). Other predictors included frequent changes in residence (adjusted OR = 1.57; 95% CI = 0.1, 2.2), financial support from family or partners (adjusted OR = 0.42; 95% CI = 0.2,0.8), and HIV diagnosis during current pregnancy (adjusted OR = 0.30; 95% CI = 0.1,0.7). Conclusions. Women more commonly experienced violence during than after their pregnancy, but violence was best predicted by socioeconomic and behavioral indicators whose influence did not vary over time.