Abstract
<title>Abstract</title> <p>Intimate partner violence (IPV) is associated with reduced access to HIV testing, yet it remains unclear whether this relationship differs depending on marital status in Southeast Asia. Within the Sustainable Development Goals (SDGs), the commitment to “leave no one behind” (LNOB) requires HIV programmes to serve populations whose vulnerability may be obscured, including among the general population of women. We analysed Demographic and Health Survey data from 2010–2022 to examine whether experiences and acceptability of violence are associated with lifetime HIV testing among 124,774 women aged 15 to 49 in Cambodia and the Philippines, and whether these associations differ depending on marital status. Married women who reported any experiences of violence had lower odds of lifetime HIV testing in Cambodia (adjusted odds ratio (aOR):0.75; 95% confidence interval (95%CI):0.67–0.84), but not in the Philippines (aOR:0.93; 95%CI:0.83–1.03). Married women from both Cambodia (aOR:1.79; 95%CI:1.64–1.95) and the Philippines (aOR:1.59; 95%CI:1.32–1.92) who could refuse sex with their husband had higher odds of lifetime HIV testing. Formerly married women who experienced violence had higher lifetime HIV testing in both Cambodia (aOR:1.52; 95%CI:1.09–2.11) and the Philippines (aOR:1.64; 95%CI:1.15–2.35). Our findings suggest that women in violent unions face relational and structural barriers to testing despite heightened HIV vulnerability. HIV responses guided by key population frameworks may insufficiently capture relational and socio-legal constraints shaping women’s access to care. Operationalising LNOB within HIV programming therefore requires violence-informed HIV testing strategies that address gender norms, relationship power, and socio-legal conditions that influence women’s safe and confidential access to services, while recognising diverse lived experiences and avoiding approaches that reinforce avoidable inequalities.</p>