학술논문

Risks of Intimate Partner Violence for Women Living with HIV Receiving Cash Transfers: A Qualitative Study in Shinyanga, Tanzania
Document Type
article
Source
AIDS and Behavior. 27(8)
Subject
Mental Health
Pediatric AIDS
HIV/AIDS
Behavioral and Social Science
Basic Behavioral and Social Science
Violence Against Women
Clinical Research
Violence Research
Infectious Diseases
Pediatric
Gender Equality
Peace
Justice and Strong Institutions
Adolescent
Adult
Female
Humans
Middle Aged
Young Adult
HIV Infections
Intimate Partner Violence
Qualitative Research
Risk Factors
Sexual Behavior
Tanzania
Behavioral economics
Cash transfers
HIV
Intimate partner violence
Gender-based violence
Public Health and Health Services
Social Work
Public Health
Language
Abstract
Cash transfers are increasingly used to motivate adherence to HIV care. However, evidence on cash transfers and intimate partner violence (IPV) is mixed and little is known about their safety for women living with HIV. We conducted in-depth interviews with women living with HIV who participated in a randomized trial providing 6 months of cash transfers (~$4.5 or $11 USD) conditional on HIV clinic attendance in Shinyanga, Tanzania to assess how receiving cash affects IPV and relationship dynamics. Eligible participants were 18-49 years, received cash transfers, and in a partnership at baseline. Data were analyzed in Dedoose using a combined inductive-deductive coding approach. 25 interviews were conducted between November 2019-February 2020. Women's employment was found to be a source of household tension and violence. None of the participants reported physical or sexual IPV in relation to cash transfers, however, some women experienced controlling behaviors or emotional violence including accusations and withholding of money, particularly those who were unemployed. Cash transfers were predominantly used for small household expenses and were not viewed as being substantial enough to shift the financial dynamic or balance of power within relationships. Our findings suggest that small, short-term cash transfers do not increase physical or sexual IPV for women living with HIV however can exacerbate controlling behaviors or emotional violence. Modest incentives used as a behavioral nudge to improve health outcomes may affect women differently than employment or larger cash transfers. Nonetheless, consultations with beneficiaries should be prioritized to protect women from potential IPV risks.