Hidden harms: Women's narratives of intimate partner violence in a microbicide trial, South Africa

Jonathan Stadler, Sinead Delany-Moretlwe, Thesla Palanee, Helen Rees Social Science & Medicine, 2014; dx.doi.org/10.1016/j.socscimed.2014.03.021 Hidden harms: Women's narratives of intimate partner violence in a microbicide trial, South Africa

Biomedical trials need to be better equipped to deal with partner violence and conflict. A social science sub-study nested within the Microbiocide Development program (MDP) investigated the connection between trial participation and experiences of partner violence. In 401 interviews with 150 women, more than a third reported intimate partner violence (IPV). Half of these instances were directly related to the women’s involvement in the trial.

The findings point to the role of social scientific enquiry in identifying hidden impacts of trial participation. They raise issues about the extent to which clinical staff are sensitive to the social context in which their trials are undertaken.

Everyday violence that some women experienced tended to be hidden from the purview of clinic staff. This is partly because of how harm was defined at the site as resulting in ‘medical conditions’, an explicitly biomedical framework that favours physical evidence and obscures less ‘obvious’ forms of violence.

Solutions such as provision of individual and couples counseling, as well as social and legal referral, could impact the ethical conduct of clinical trials and the future of female-controlled technologies to prevent HIV.

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