Magnitude of intimate partner violence and its associated factors among HIV-positive women attending health facilities in Ethiopia: a systematic review and meta-analysis

Abstract

Background

Worldwide, over one in three women have experienced intimate partner violence; among women who have been diagnosed as positive for human immunodeficiency virus (HIV), the number is significantly greater due to the detrimental effects of this virus. Despite its serious consequences, there is limited comprehensive data on IPV among HIV-positive women in Ethiopia. Thus, this review aimed to find out the pooled prevalence and associated factors of IPV in this group.

Methods

For this review, searches were conducted from October 1, 2024, to November 2, 2024, using Google Scholar, Medline, PubMed, the Cochrane Library, Web of Science, and other institutional repositories. A standardized data extraction checklist with three data extractors and STATA version 17 was utilized for data extraction and analysis, respectively. The heterogeneity of the studies was checked using the Cochrane Q test statistics and I² statistics. A random-effects model was utilized to assess the pooled prevalence of intimate partner violence. An odds ratio with a 95% confidence interval was used to assess the association between intimate partner violence and independent factors. Egger’s test and a funnel plot were employed to evaluate publication bias. Subgroup analysis was carried out based on publication years and study setting.

Results

This systematic review and meta-analysis included 2704 study participants from seven studies. As identified from the current systematic review and meta-analysis, the pooled prevalence of intimate partner violence among women living with HIV was 51.45% (95% CI 44.05, 58.85). Having multiple partners (OR = 2.12, 95% CI 1.40, 2.84), women experiencing controlling behavior by a partners (OR = 5.95, 95% CI 3.56, 8.35), partners who drink alcohol (OR = 2.23, 95% CI 1.45, 3.01), and partners involved in a physical fight with another man (OR = 2.02, 95% CI 1.10, 2.94) were identified as factors.

Conclusion and recommendation

This review found that one in two HIV-positive women in Ethiopia experienced intimate partner violence, raising concerns about the increased risk of viral transmission. Factors identified included women having multiple partners, controlling behavior by partners, partner alcohol use, and partners involved in physical fights. Stakeholders should address the identified risk factors to reduce intimate partner violence among HIV-positive women. Integrating IPV screening into HIV care, training healthcare workers, and promoting community education are helpful.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-24907-2.

Introduction

Throughout their lives, women encounter a variety of man-made problems most of which are the result of ingrained cultural and socially built misconceptions. Intimate partner violence (IPV) is among the common violence women face daily in their lives [1]. It is a global issue that is explained as when women experience physical, sexual, psychological, or controlling behaviors in their relationships, whether they are in a union or not [2]. It is a severe and widely disseminated problem that is often overlooked and underappreciated, putting the victim in danger for both psychological and physical harm [2, 3]. Women are generally susceptible to IPV, regardless of ethnicity, employment, and other factors, although the impact may vary globally. However, the problem is exaggerated and severe among some groups, like women living with human immunodeficiency virus (HIV+) [4].

The World Health Organization (WHO) recognized that there is a strong correlation between HIV and intimate partner violence [5]. Women and girls with HIV + who experience intimate partner violence against greatly increase HIV direct transmission through sexual violence, decreased drug adherence, fear of dealing with condom use, and fear of violence if discussed issue of HIV about their results [6].

A recent WHO report and Global IPV Studies indicate that about 27% (uncertainty interval 23–31%) of women aged 15–49 who have ever been in a relationship have suffered intimate partner violence at some point in their lives, either sexually or physically [7, 8]. Although this figure varies by country, it is higher in sub-Saharan countries, where it ranges from 22 to 43%, followed by Oceania, where it is 19 to 40%. In contrast, the prevalence is remarkably low in developed countries, ranging from 3 to 8% in Europe and America [7]. The prevalence is significantly higher among people with HIV + than in the general population. For instance, data shows that 55% of women and 20% of men living with HIV + encounter intimate partner violence (IPV), and 24% of women report experiencing abuse from their partners after reporting their HIV serostatus diagnosis [9]. The problem is more prevalent in low-income countries like Ethiopia, in which the prevalence ranges from 28.3% to 69% [10–12].

Intimate partner violence (IPV) among HIV-positive women significantly exacerbates personal, social, economic, and psychological burdens. Studies consistently demonstrate that IPV is associated with poor engagement in HIV care, including delayed initiation of antiretroviral therapy (ART), decreased adherence, and lower rates of viral suppression. For instance, women experiencing IPV are more likely to miss clinic appointments, forget to take medications, or discontinue treatment due to fear of partner retaliation or psychological distress. Furthermore, IPV hinders open communication about health and reproductive issues, including condom use, due to fear of violence. This often leads to non-disclosure of HIV status, increasing the risk of transmission within families and communities. The compounded effects of IPV and HIV create a vicious cycle, where each exacerbates the impact of the other [13–15].

Goal 5 of the Sustainable Development Goals (SDGs), which aims to empower all women and girls and achieve gender equality, includes solutions expressly created to combat intimate partner violence (IPV) that affects women with HIV. Important strategies include community-based interventions, trauma-informed and survivor-centered treatment, integrating GBV services into HIV care, and establishing supporting legislative and policy frameworks. However, there are a number of interrelated reasons why SDG efforts have failed to reduce intimate partner violence (IPV) and, in some cases, have made it worse. It is difficult for women to seek assistance and for interventions to be successful in many communities because of cultural norms that normalize or excuse violence against women. Moreover, the efficacy of IPV interventions is further hindered by economic inequality and inadequate legal frameworks. Alongside this, SDG target 3.3 calls for the eradication of AIDS by 2030 [16]. Despite all of the negative effects of IPV, Ethiopia is now among the low-income countries where HIV prevalence has increased recently [17].

In nations like Ethiopia, where gender inequality and a higher prevalence of HIV coexist, IPV has a double impact on women living with HIV. There is a scarcity of comprehensive studies regarding this specific topic; only a couple of the primary investigations were conducted in different parts of the country, reporting variations in prevalence and contributing factors. Thus, this systematic review and meta-analysis would provide robust evidence on the prevalence and contributing factors of IPV among women living with HIV that might help inform the development of integrated intervention strategies. Moreover, this review would not only help Ethiopian women but also add important knowledge to the worldwide community on the intersection of HIV and IPV, especially in settings with limited resources.

Methods

Study setting

A systematic review and meta-analysis were conducted to find out the pooled prevalence of IPV and associated factors among women living with HIV attending health facilities found in Ethiopia. Ethiopia is one of the low-income countries located in the Horn of Africa, with a 2022 projected population of 123.4 million, 133.5 million in 2032, and 171.8 million in 2050 [18]. For administrative purposes, Ethiopia has two city administrations and twelve regions based on recent data. Regions are further classified into zones, and zones are divided into districts. Finally, districts are divided into kebele (the smallest administrative division contains 2000 up to 3500 residents) [19]. According to a recent systematic and meta-analysis study, 31.6% of women experienced intimate partner violence. As supported by other studies carried out throughout the country, the prevalence among women living with HIV is far higher than this number [20]. Ethiopia’s HIV prevalence varies by location, but according to a national report, it is approximately 0.9% [21].

Search strategies, study design and sources of information

Initially, the database of abstracts of reviews of effects (DARE) (http://www.library.UCSF.edu) and the PROSPERO database were checked to see if there was any ongoing or published work on the topic. Then this systematic review and meta-analysis were registered in the PROSPERO database with Id no of CRD42024609503. Searching for research articles, identifying studies, extracting data, and reporting findings were all done in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [22]. The studies were found through internet searches using databases of MEDLINE/PubMed, Google Scholar, EMBASE, HINARI, Cochrane Library, ProQuest, African Journals Online, and online university repositories (Hawasa University, University of Gondar, Bahardar University, Addis Ababa, Jimma, and Haramaya University) and reference lists of previous prevalence studies. The search was done using the following keywords individually or in combination: intimate partner violence, domestic violence, prevalence, women living with HIV, Ethiopia. The review was done from the previous studies that published and unpublished that were written in the English language, and the limit for the study category was human. The search of studies was carried out from October 1, 2024, to November 2, 2024.

Eligibility criteria

This review comprised the studies solely carried out in Ethiopia regarding IPV among women living with HIV/AIDS. The review included both published and unpublished articles. Additionally, all observational study designs (i.e., cross-sectional, case-control, and cohort) reporting the prevalence of IPV were eligible for this meta-analysis. Finally, we took into consideration papers that were written only in English. However, after examining their full texts, studies that did not mention our outcome of concern were excluded. Furthermore, while analyzing associated variables, the studies that only reported a crude odds ratio without an adjusted odds ratio for associated factors were excluded from the analysis of factors.

Data extraction and quality assessment

In this review, we used Microsoft Excel and three data extractors (SS, GG, and MR) to extract data based on a standard checklist. Initially, data extractors scanned all articles to check for duplicates and then removed them accordingly. Then, based on their titles and abstracts, research articles were assessed and excluded. Full-text publications were used as a framework for assessing the additional information’s that were required. The all database search results were then combined using management software Endnote version X21.4. Following that, the primary studies’ eligibility was evaluated in accordance with the predetermined inclusion and exclusion criteria. The names of the authors, the year of publication, the study design, the sample size, the response rate, the number of participants, and the location (a region where studies were done) were all included in the data extraction checklist for the initial outcome (IPV). For the second outcome (factors associated with IPV), data were obtained in two-by-two table formats, and the log OR was calculated using the source papers’ findings. Differences between the three independent reviewers were settled by adding more reviewers (WT, LM, BF, and EZ following discussion for possible consensus. Finally, the Joanna Briggs Institute (JBI) quality appraisal checklist assessment instrument was employed to appraise the quality of the included studies [23].

Operationalization of outcome measures

The outcome variable IPV among women living with HIV is defined as stalking or emotional, physical, or sexual abuse that takes place between individuals with close relationships, such as current or past spouses and lovers [24]. The second objective of this study was to identify factors associated with IPV among women living with HIV. Consequently, the association between IPV and associated variables was determined using the log odds ratio. All of the studies that were part of this meta-analysis assessed intimate partner violence against women using a tool that adapted from the WHO Multi-country Study on Women’s Health and Domestic Violence tool in low-income countries [25].

Data processing and analysis

The candidate research data were exported to STATA version 17.0 following the evaluation of the first phase, and the pooled effect size with 95% CI was then computed. The Cochran Q test (Chi-squared statistic) and I² statistic on forest plots were calculated to assess heterogeneity among the included studies. A p-value of less than 0.05 indicates statistical significance for the Cochran’s Q statistical heterogeneity test. The range of I² statistics is 0 to 100%, and values of 0, 25, 50, and 75% were regarded as indicating no, low, moderate, and high levels of heterogeneity, respectively [26]. When significant heterogeneity was found for dependent and independent outcomes, the pooled prevalence of IPV and the pooled effect size of related covariates were calculated using a random-effects model. To figure out whether statistically significant heterogeneity was present, meta-regression was performed for an assessment of publication bias, a funnel plot was used. Additionally, the absence of publication bias was examined using Begg’s tests and Egger’s weighted regression. Statistical non significance of publication bias was declared at a p-value of greater than 0.05. Point prevalence, as well as 95% confidence intervals, was presented in a forest plot format. In this plot, the size of each box indicated the weight of the study, while each crossed line referred to 95% confidence interval. For the secondary outcomes, a log odds ratio was used to determine the association between IPV and associated factors.

Result

Identified studies

In this systematic and meta-analysis study, we retrieved 1151 publications from all databases. Of these, 761 studies were eliminated as duplicates, and 369 were eliminated after their titles and abstracts were examined because they did not meet our review’s targets. After the entire texts of the remaining twenty-one studies were examined, the fourteen papers that didn’t meet the predefined eligibility requirements were omitted. Finally, we retrieved seven publications that successfully meet all of the review’s requirements (Fig. 1).

Fig. 1.

PRISMA flow diagram of included studies in the systematic review and meta-analysis of the exploring intimate partner violence and its associated factors among HIV positive women attending health facilities in Ethiopia, 2024

Characteristics of included studies

All seven of the papers included in this review were published in various peer-reviewed journals and institutional repository between 2019 and 2023. In this systematic and meta-analysis, 2704 HIV-positive women were included from those studies [27–32]. In terms of sample size, the study carried out in Addis Ababa had the smallest sample size (128) [30], while the study from Gondar city in the Amhara region had the greatest sample size (630) [10]. In regard to the year of study, three of the studies were undertaken after 2020 [27, 28], while four were conducted prior to 2020 [29–32]. Six of these studies had a cross-sectional study design [27–29, 31, 32], and a case control research design was used in one of these researches [30]. Regarding the study setting, three of these studies were carried out in the Oromia region [28, 29, 31], one in the Amhara region [10], one in the SNNP [32], one in the Sidama region [27], and the remaining one in the Ethiopian capital, Addis Ababa [30] (Table 1).

Table 1.

Characteristics of included studies on IPV among women with HIV in Ethiopia, 2024

Authors	Year of publication	Region	Study area	Study design	Sample size	Response rate	Quality Score	Prevalence of IPV	SE
Goyomsa et al.(32)	2022	Oromia	Adama	Cross-sectional study	396	100%	7 points	45.5	2.50
Diribe et al.(30)	2016	Oromia	Fitche	Cross-sectional study	311	100%	7 points	46	2.8
Alemie et al.(28)	2023	Amhara	Gondar	Cross-sectional study	630	99.4%	8 points	64.2	1.91
Biranu et al.(29)	2023	Oromia	Nekemte	Cross-sectional study	420	100%	8 points	49.29	2.43
Meskele et al.(33)	2019	SNNR	Wolaita Sodo	Cross-sectional study	408	100%	8 points	61.3	2.41
Beletu A.(27)	2022	Sidama	Hawassa	Cross-sectional study	411	100%	7 points	41.9	2.43
Deyessa N. (31)	2018	Addis Ababa	Addis Ababa	Case-control	128	95.5%	8 points

In the above table, the prevalence from Deyessa N.’s paper is not reported as it is not applicable for a case-control study design

Prevalence of intimate partner violence among women living with HIV positive

As revealed from this meta-analysis, high heterogeneity was observed across the included studies (I2 = 93.33%, p < 0.001). As a result, a random-effects model was used to estimate the pooled IPV among women living with HIV. Thus, the pooled prevalence of IPV was 51.45% (95% CI 44.05, 58.85). IPV prevalence among women with HIV was shown to have been highest in Amhara region Gondar city (64.20, 95% CI 60.46, 67.94), whereas the lowest prevalence was found in the Sidama region of Hawassa city (41.90, 95% CI 37.13, 46, 67) (Fig. 2).

Fig. 2.

Forest plot of the pooled estimate of the prevalence of IPV among women living with HIV positives in Ethiopia, 2024

Meta regression

A meta-regression analysis was conducted to explore potential sources of heterogeneity among the included studies, using the year the study was conducted and the sample size as covariates. The analysis revealed that, while the year of study did not significantly influence the outcomes, sample size remained a statistically significant predictor. This suggests that variations in sample size across studies may contribute to differences in effect sizes, indicating that larger or smaller studies may systematically report different outcomes (Table 2).

Table 2.

Meta regression on the prevalence of IPV among women living with HIV in Ethiopia, 2024

_meta_es	Coefficient	Std. err.	Z	P>|z|	[95% conf. interval]
Year of study conducted	−1.899	1.367	−1.39	0.165	(− 4.579, 0.780)
Sample size	0.091	0.035	2.57	0.01	(0.021, 0.161)
_cons	3847.75	2751.01	1.40	0.162	(− 1544.13, 9239.64)

Subgroup analysis

Subgroup analysis was carried out based on the region in which the studies were done and the length of time those studies were conducted in order to identify heterogeneity among the included studies. According to the region where the original studies conducted, the highest prevalence of IPV among women living with HIV was from others (Amhara, SNNR, and Sidama): 51 (95% CI 44.0, 57.0, I² = 93.92 and p = 0.00) [10, 27, 32] and whereas it was lower in Oromia, in which 47 (95% CI 44.0, 50.0) [28, 29, 31] (Fig. 3). The prevalence report varied somewhat depending on when the study was conducted: 51 (95% CI 40.0, 61.0, I² = 93.92 and p = 0.00) studies were undertaken between 2014 and 2019 [29, 31, 32], and 52 (95% CI 38.0, 65.0) studies were conducted between 2020 and 2023 [27, 28] (Fig. 4).

Fig. 3.

Subgroup analysis of the prevalence of IPV among women living with HIV positives in Ethiopia based on the region, 2024

Fig. 4.

Subgroup analysis of the prevalence of IPV among women living with HIV positives in Ethiopia based on the year of study conducted, 2024

Publication bias

Egger’s test at the 5% significance level, along with a graphical funnel plot, was used to assess publication bias. While the funnel plot appeared symmetrical (Fig. 5), Egger’s test indicated significant publication bias (p = 0.009), necessitating the use of trim-and-fill analysis.

Fig. 5.

Funnel plot with 95% confidence limit of the prevalence IPV among women living with HIV positive in Ethiopia, 2024

Nonparametric trim-and-fill analysis of publication bias

This review demonstrated the existence of publication bias in the included papers. Therefore, a nonparametric trim-and-fill analysis of publication bias was conducted. The findings showed that if the five papers imputed in the study were included, the overall prevalence would increase to (52.93, 95% CI 51.03, 54.83).

Leave one out sensitivity analysis

Sensitivity analysis identified outliers, demonstrating that no single study had an impact on the total number of included studies. (Table 3).

Table 3.

Leave one out sensitivity meta-analysis on six studies on the prevalence of IPV among women living with HIV in Ethiopia, 2024

Omitted study	Effect size	[95% conf. interval]	P-Value
Goyomsa et al.	52.624	[95% 44.041, 61.208]	0.000
Diribe et al.	52.501	[95% 43.855, 61.146]	0.000
Alemie et al.	48.827	[95% 42,233, 55.421]	0.000
Biranu et al.	51.863	[95% 42,874, 60.852]	0.000
Meskele et al.	49.487	[95% 41.714, 57.260]	0.000
Beletu A.	53.369	[95% 45,566, 61.171]	0.000
theta	51.450	[95% 44.047, 58.854]	0.000

Factors associated with intimate partner violence among women living with HIV

Association between male multi-partnership and IPV

One factor associated with intimate partner violence was male multi-partnership. Two studies were selected to investigate the association between male multi-partner relationships and intimate partner violence among women living with HIV [10, 31]. The pooled association between male multi-partner and IPV was estimated by a random-effects model (I² = 0.0%, P-value = 0.318). Thus the pooled result of the analysis indicates that there was no association between male multi-partner relationships and IPV (OR = 1.59, 95% CI 0.81, 2.38). (Fig. 6)

Fig. 6.

Forest plot of the pooled estimate of the association between male multi-partnership and IPV among HIV-positive women in Ethiopia, 2024

Association between women having multiple partners and IPV

To examine the women having multiple partners and intimate partner violence among women living with HIV, two studies were included [30, 32]. The pooled association between the number of partners women had and IPV was estimated by a random effects model (I² = 0.0%, P-value = 0.751). The finding showed that there was a significant association between the number of partners women had and intimate partner violence. Women having multiple partners had 2.12 higher than those affected by IPV, those of a single partner (OR = 2. 12, 95% CI 1.40, 2.84). (Fig. 7)

Fig. 7.

Forest plot of the pooled estimate of the association between the women having multiple partners and IPV among HIV-positive women in Ethiopia, 2024

Association between experiencing controlling behavior by a partner and IPV

Three papers were included to investigate IPV and experiencing controlling behavior by a partner among women living with HIV [28, 29, 32]. The pooled association between controlling behavior by a partner and IPV was estimated by a random effects model (I² = 2.8%, P-value = 0.358). The result revealed that women whose partner showed controlling behavior were 5.95 times more likely to have experienced IPV than their counterpart (OR = 5.95, 95% CI 3.56, 8.35). (Fig. 8)

Fig. 8.

Forest plot of the pooled estimate of the association between experiencing controlling behavior by a partner and IPV among HIV-positive women in Ethiopia, 2024

Association between partner drink alcohol and IPV

Three research studies included in the review found that partner drinking alcohol was a variable linked to IPV [10, 27, 32]. A random effects model was used to determine the pooled association between IPV and controlling behavior by a partner (I² = 0.0%, P-value = 0.973). Women partners who drank alcohol were 2.23 times more likely to have experienced IPV than those who did not (OR = 2.23, 95% CI 1.45, 3.01). (Fig. 9)

Fig. 9.

Forest plot of the pooled estimate of the association between partner drinking alcohol and IPV among HIV-positive women in Ethiopia, 2024

Association between partner involved in physical fight with other man and IPV

Two studies were included to examine the association between IPV among women living with HIV and partners who engage in physical conflicts with other men [27, 32]. The pooled association between IPV and controlling behavior by a partner was calculated using a random effects model (I² = 0.0%, P-value = 0.492). Therefore, compared to their counterparts, women whose partners engaged in physical fights with other men were 2.02 times more likely to have experienced intimate partner violence. (OR = 2.02, 95% CI 1.10, 2.94). (Fig. 10)

Fig. 10.

Forest plot of the pooled estimate of the association between partner involvement in a physical fight with another man and IPV among HIV-positive women in Ethiopia, 2024

Discussion

This systematic review and meta-analysis assessed intimate partner violence and associated factors among women living with HIV in Ethiopia, 2024. As identified from this review, the pooled prevalence of IPV was 51.45% (95% CI 44.05, 58.85). This study’s results are consistent with an across the nation survey (44.2%) done in Uganda [33]. This is supported by available evidence suggesting a moderately statistically significant association between IPV and HIV infection among women [34, 35]. The result of this review, however, was higher than the 29.1% found in a study assessing nationally representative research in sub-Saharan Africa [36], in Burkina Faso, which was 26% [37], and the national report from India, which was 35.49% [38]. This occurrence could be attributed to research done in many countries with diverse socioeconomic and cultural origins and women’s values. Additionally, while the prior study only looked at physical and sexual violence, ours focuses on intimate partner violence in general. Furthermore, the methodologies used to investigate IPV may have an impact on the prevalence, as the earlier studies were compiled from several national data sources.

In the same way, the results of this review were higher than those of the United States study, which found that 11.8% of HIV-positive women had experienced intimate partner violence [39]. This study’s disparity may result from the socio-demographic, economic, and cultural practices of the two populations differing from one another. Another explanation for the disparity is that the first study was conducted in the most developed and civilized nation, which might have decreased the prevalence.

However, the review’s results were lower compared to that of the population-based study in Uganda, which found that 72.22% [40]. This may be because the Uganda study’s participants were women who were diagnosed with HIV within the first six months of their diagnosis. They may have more arguments with their partner since they are not psychologically stable or ready to accept the implications of their serostatus given that they are unprepared for it. Similarly, this review’s findings were below the 63% found in Zambia’s [37] national report. Disparities in national, cultural, and geographic HIV reporting may account for this.

Women having multiple partners had 2.12 more likely to face violence than their counterparts, according to this systematic review and meta-analysis. This is supported by the study conducted in South Africa [41]. This could be because of the partner’s feelings of love, jealousy, and ownership over his ladies. Furthermore, it is considered unacceptable for a woman to be in another relationship in many nations, such as Ethiopia, where social, cultural, and spiritual traditions are strictly adhered to.

This review also found that those women whose partner exhibited controlling behavior were about 6 times more likely to experience intimate partner violence than their counterpart. Studies conducted in Nigeria [42], Uganda [43], Turkey [44], and Spain [45] support this. The possible explanation for this is that men of this type believe that if a woman leaves, she may be afraid for her life or the safety of her children, she may not have a place to go, she may not be financially independent, and she may still be in love with him, which leads to such violence.

According to the results of this systematic and meta-analysis research, women who have an alcoholic partner were about 2.2 times more likely to experience intimate partner violence. This is supported by the review carried out during COVID-19 in Ethiopia [20]. Likewise, Tanzania supported the study’s findings [46]. This might be the consequence of the alcohol altering the person’s thinking to rationalize such misconduct. Furthermore, an alcoholic might have an argument with someone in the bar, on the street, or somewhere else; this causes conflict with his partner even at home, which can escalate into violence. Furthermore, due to factors like the timing of the partner’s return home, the money he spends on alcohol, the time he spends with his family, and other concerns, disagreements may occur between women and men that lead to violence.

Lastly, this systematic review and meta-analysis found that women whose partners engaged in physical fights with other men were significant factors in IPV among HIV-positive women. Women whose partners fight with other men were about 2 times more likely to experience intimate partner violence. There is evidence to corroborate this from the UN Multi-country research [47]. This might be due to the fact that males who act violently when they are arguing with other males may continue to act aggressively in their personal lives, which might result in domestic violence. This trend can be caused by a number of things, including taught behavior, problems with emotional control, and cultural norms that support violence.

Strength and limitation

The primary strength of this review is that by pooling information from several studies, the review offers an aggregate result of the prevalence of IPV together with associated factors among Ethiopian women living with HIV, which helps improve the findings’ generalizability; hence, the issue is a current national and worldwide concern. Additionally, this systematic review and meta-analysis include the use of multiple databases to find literature, the inclusion of relevant studies following a thorough quality evaluation, and the search of both published and unpublished studies. It is challenging to obtain an accurate estimate of publication bias from the funnel plot because less than ten papers were included in the final analysis.

Conclusion

According to this systematic review and meta-analysis, one in two HIV-positive women in Ethiopia experienced intimate partner violence which is concerning and could increase the risk of viral transmission. Women having multiple partners, women experiencing controlling behavior by a partner, partners drinking alcohol, and partners involved in a physical fight with another man were identified as factors. Health professionals and health extension workers should explore the intimate partner violence issues with their clients. In addition to screening such women, providing them with psychological support, and promoting communication with their partner, it is recommended that prospective stakeholders incorporate IPV screening into HIV care and healthcare worker training, as well as community education initiatives. Furthermore, it is recommended that the concerned bodies implement interventions that include programs addressing substance abuse within relationships. Future researchers are recommended to explore the causes of intimate partner violence (IPV) among HIV-positive women to help mitigate the consequences of this double burden. Additionally, addressing this issue at the community level is encouraged.

Abbreviations

CI

Confidence Interval

HIV

Human immunodeficiency virus

CI

Confidence Interval

IPV

Intimate Partner Violence

OR

Odds Ratio, Women

SDG

Sustainable Development Goals

UN

United nation

Authors’ contributions

Author ContributionsConceptualization: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleData curation: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleFormal analysis: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleFunding acquisition: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleInvestigation: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleMethodology: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleProject administration: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleResources: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleSoftware: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleSupervision: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleValidation: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleVisualization: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleWriting – original draft: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan BekeleWriting – review & editing: Solomon Seyife Alemu, Meseret Robi Tura, Wubet Tazeb Wondie, Lema Mideksa Egu, Belete Feyera Olkaba, Ebisa Zerihun, Belay Tafa Regassa, Nimona Amena, Lema Fikadu Wedajo, Gemechu Gelan Bekele.

Funding

The authors received no specific funding for this work.

Data availability

All relevant data are within the paper and its Supporting information files.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.