The social, cultural, and health context of controlling behavior and emotional intimate partner violence among adolescent girls and young women living with human immunodeficiency virus in Uganda: A qualitative study

Background: Many adolescent girls and young women (AGYW) living with human immunodeficiency virus (HIV) report intimate partner violence (IPV), including emotional IPV and controlling behavior. Yet, few studies have examined the association between these forms of IPV and health outcomes among AGYW living with HIV.Objectives: We conducted an exploratory qualitative study to understand the contexts in which controlling behavior and emotional IPV might impact the health of AGYW living with HIV in Uganda.Design: We used a participatory action research design involving community stakeholders (health workers, program managers of non-governmental organizations serving IPV survivors, and AGYW living with HIV).Methods: Data were collected through in-depth interviews and focus groups. We analyzed data using an inductive thematic analysis approach.Results: The following four themes related to different dimensions of controlling behavior and emotional IPV among AGYW living with HIV emerged from the data: (1) age-related controlling behavior and emotional IPV; (2) HIV-related controlling behavior and emotional IPV; (3) isolation-type controlling behavior and poor HIV health; (4) financial control and poor HIV health. Embedded throughout the four themes were issues related to male partners' misuse of power.Conclusion: AGYW living with HIV experience unique forms of emotional IPV and controlling behavior that impede their ability to remain healthy. Inequitable gender norms may further increase the risk of emotional IPV and controlling behavior among AGYW living with HIV. Couples-based interventions that build healthy relationship skills and offer social support may help to reduce these forms of IPV.