Housing and Water Insecurity as Structural Predictors of Intimate Partner Violence: A Cross-Sectional Study of People Living with HIV.

Intimate partner violence (IPV) remains a major public health concern globally, particularly among people living with HIV (PLHIV). While prior research has focused on individual and interpersonal factors, less attention has been given to structural determinants such as housing and water insecurity. This study examines associations between these insecurities and emotional, physical, and sexual abuse among PLHIV in Kenya. Data were drawn from a cross-sectional study (N = 1,132), with 515 participants aged ≥ 16 years completing IPV measures. Descriptive, bivariate, and multivariable generalized linear models were used. Overall, 40.6% reported emotional abuse, 19.6% physical abuse, and 7.6% sexual abuse. Greater water insecurity was associated with increased odds of emotional abuse (AOR = 1.03, 95% CI: 1.01–1.05) and physical abuse (AOR = 1.04, 95% CI: 1.01–1.07), but not sexual abuse. Housing insecurity was associated only with emotional abuse (OR = 1.45, 95% CI: 1.21–1.73). Addressing structural inequities may reduce IPV and improve health outcomes.