Intersecting Realities: African American Women’s Experiences with HIV and Intimate Partner Violence (IPV) In the Southern United States

Background and Purpose:
Intimate partner violence (IPV) and human immunodeficiency virus (HIV) are intersecting public health concerns that disproportionately affect African American women in the Southern United States. Although prior research has examined IPV and HIV independently, limited research explores their intersection and the lived experiences of women navigating both conditions simultaneously. This study aims to address this gap by examining how African American women experience the intersection of IPV and HIV, including the social, emotional, and structural factors shaping their experiences, as well as the resources and resilience strategies that support their well-being.

Methods:
This exploratory qualitative study utilized a cross-sectional design with embedded quantitative components. Data were collected from a purposive sample of 28 African American women living with HIV who reported a history of IPV. Participants were recruited through a community-based organization hosting a regional conference for women living with HIV in the Southern United States. Four focus groups (two in-person and two virtual) were conducted using a semi-structured interview guide. Discussions explored participants’ experiences with IPV and HIV, their perceived intersection, and impacts on relationships, mental health, and access to resources. Sessions were audio-recorded, transcribed verbatim, and analyzed using thematic analysis with an inductive approach. Quantitative demographic and contextual data were collected via a structured survey to complement qualitative findings.

Findings:
Analysis revealed five major themes: (1) IPV experiences, (2) HIV experiences, (3) subsequent relationships, (4) resources, and (5) resilience. Participants reported multiple forms of IPV, including physical, sexual, psychological, financial abuse, and stalking, often occurring before, during, or after HIV diagnosis. Many women described IPV as contributing to their HIV risk through coercion, control, and reduced ability to negotiate safe practices. HIV status was frequently used by perpetrators as a tool of psychological abuse, reinforcing stigma, isolation, and dependence.

Participants experienced significant emotional challenges, including depression, anxiety, fear, and internalized stigma, which often delayed healthcare engagement. IPV and HIV experiences also affected participants’ ability to form and maintain future relationships due to mistrust and fear of disclosure. Despite these challenges, women identified critical resources, including mental health services, peer support, advocacy groups, and open dialogue, as essential for recovery. However, barriers such as limited access to transportation, childcare, technology, and awareness of services were frequently reported. Notably, participants demonstrated resilience through personal growth, empowerment, and engagement in advocacy and support networks.

Conclusion and Implications:
Findings highlight the complex and interconnected nature of IPV and HIV among African American women, underscoring the need for integrated, trauma-informed, and culturally responsive interventions. Social work practice should prioritize co-located services, peer support models, and provider training to address stigma and improve access to care. Policies and programs must center the lived experiences of African American women to effectively address structural inequities and promote long-term well-being.