1. 9/9/20151 Violence Against Women and HIV/AIDS Prevention: Update from CDC’s Division of HIV/AIDS Prevention Linda J. Koenig, PhD, MS Senior Scientist, Prevention Research Branch Division of HIV/AIDS Prevention HIV & Violence Against Women: A National Conference August 22, 2009; Atlanta, GA

2. 9/9/20152 Early activities: Collaboration and agenda setting 1998-99: DHAP co-sponsored 2 meetings to bring attention to role of abuse/violence in HIV risk and prevention 1998-99: DHAP co-sponsored 2 meetings to bring attention to role of abuse/violence in HIV risk and prevention –“Childhood Sexual Abuse and HIV Risk: Breaking the Link”, November, 1998, Atlanta, GA (CDC/NIMH) CSA as risk for HIV CSA as risk for HIV www.apa.org/books www.apa.org/books www.apa.org/books – “National Conference on Violence and Reproductive Health: Science, Prevention & Action”, June 1999, Atlanta, GA (CDC cross-CIO collaboration) For HIV, co-occurring epidemics with interrelationships For HIV, co-occurring epidemics with interrelationships MCHJ, vol 4[2] June 2000 MCHJ, vol 4[2] June 2000 Outgrowth: raise awareness about need to bring disparate fields/services together Outgrowth: raise awareness about need to bring disparate fields/services together

3. 9/9/20153 Developing the science base Documenting the high prevalence of adult violence and childhood abuse among women with or at high risk for HIV infection, and the impact of violence/abuse on safe sex practices Documenting the high prevalence of adult violence and childhood abuse among women with or at high risk for HIV infection, and the impact of violence/abuse on safe sex practices –Henny KD, Kidder D, Stall R, Wolitski RJ. (2007). Physical and sexual abuse among homeless and unstably housed adults living with HIV: Prevalence and associated risks. AIDS and Behavior, 11, 842-853. –Koenig, LJ, Whitaker, DJ, Royce, R, et al. (2006). Physical and sexual violence during pregnancy and after delivery: A prospective multistate study of women with or at risk for HIV infection. American Journal of Public Health, 96, 1052-1059. –Hamburger, ME, Moore, J, Koenig, LJ, et al. (2004). Persistence of inconsistent condom use: Relation to abuse history and HIV serostatus. AIDS and Behavior, 8, 333-344 –Koenig, LJ and Clark, H (2004). Sexual abuse of girls and HIV infection among women: Are they related? In Koenig, LJ, Doll, L, O’Leary, A, and Pequegnat, W. (Eds.) From Child Sexual Abuse to Adult Sexual Risk: Trauma, Revictimization, and Intervention. American Psychological Association Books: Washington, DC. –Saul J, Moore J, Murphy ST, Miller LC (2004). Relationship violence and women’s reactions to male- and female- controlled HIV prevention methods. AIDS and Behavior, 8, 207-214 –Koenig, LJ, Whitaker, D., Royce, R., et al. (2002) Violence during pregnancy among women with or at risk for HIV infection. American Journal of Public Health, 92: 367-370 –Koenig, LJ, and Moore, J (2000). Women, Violence, and HIV: A Critical Evaluation with Implications for HIV Services. Maternal and Child Health Journal, 4, 103-109. –Vlahav D, Wientge D, Moore J, et al. (1998). Violence among women with or at risk for HIV infection. AIDS and Behavior, 2:53-60.

4. 9/9/20154 Incorporating awareness into public health practice and HIV prevention programs Incorporated into partner services guidance (formerly PCRS) Incorporated into partner services guidance (formerly PCRS) CDC. Recommendations for partner services programs for HIV and other sexually transmitted diseases. Morbidity and Mortality Weekly Report, 2008; 57(RR9):1-63. Diffusion of Effective Behavioral Interventions (DEBI): Diffusion of Effective Behavioral Interventions (DEBI): 2 include promotion of violence screening, recognition and referral Future is Ours (FIO): Future is Ours (FIO): group-intervention for women; promotes abuse awareness; http://www.cdc.gov/hiv/topics/research/prs/resources/factshee ts/FIO.htm http://www.cdc.gov/hiv/topics/research/prs/resources/factshee ts/FIO.htm Project Connect : Project Connect : Couple’s based intervention promotes violence screening & referral http://www.effectiveinterventions.org/go/interventions/connect Gender Toolkit (CBB with OWH) Gender Toolkit (CBB with OWH) –Modeled after PEPFAR/international approach for domestic audience –promotes a gendered framework for HIV prevention, include role of gender- based violence

5. 9/9/20155 Current activities: HIV prevention for racial and ethnic minority women Program review: Program review: –Integrated services for Asian immigrant and refugee communities –Leung M and Koenig LJ. Integrated HIV and violence prevention:Promising programs for Asian immigrant and refugee communities. Tuesday, 3:30-5:00, A707 Mariott Marquis Survey Research: Survey Research: Understanding determinants of risk for African-American and Hispanic women in the southeastern United States Understanding determinants of risk for African-American and Hispanic women in the southeastern United States Intervention: Intervention: Microenterprise: promoting HIV prevention by addressing poverty –Shown in Africa to reduce both HIV and violence victimization –Current focus: poor African-American women in the southeastern U.S. –March 2006: CDC consultation Stratford D, Mizuno Y, Williams K et al. (2008) Addressing poverty as a risk for disease: Recommendations from CDC’s consultation on microenteprise as HIV prevention. Public Health Reports, 123, 9-20. –Currently developing intervention in collaboration with STD, DVP and others

6. 9/9/20156 Thank you. For further information, contact LKoenig@cdc.gov The findings and conclusions in this presentation are those of the author and don’t necessarily represent those of the Centers for Disease Control and Prevention LKoenig@cdc.gov