Clinical and Mental Health Correlates and Risk Factors for Intimate Partner Violence among HIV-Positive Women in an Inner-City HIV Clinic

Abstract

Background Intimate partner violence (IPV) is a serious health concern for women in the U.S, and HIV-positive women experience more frequent and severe abuse compared to HIV-negative women. The goals of this study were to determine the prevalence of IPV among HIV-infected women receiving care in an urban clinic and to determine the HIV clinical and mental health correlates of IPV among HIV-positive women. Methods We conducted a cross-sectional survey among 196 women visiting an inner city HIV clinic. Women were eligible if they were 18 years of age or older, English speaking and received both HIV primary and gynecological care at the clinic. The survey queried demographics, drug and alcohol history, depressive symptoms, and IPV, using the Partner Violence Scale (PVS). Antiretroviral therapy (ART), CD4 cell count, HIV-1 RNA level, and appointment adherence were abstracted from clinical records. Findings Overall, 26.5% of women reported experiencing IPV in the past year. There were no significant differences in sociodemographics, substance use, ART prescription, CD4 count or HIV-1 RNA level between women who experienced IPV and those who had not. Women with mild and severe depressive symptoms were significantly more likely to report IPV compared to those without, with adjusted odds ratios of 3.4 and 5.5, respectively. Women who missed gynecological appointments were 1.9 times more likely to report experiencing IPV. Conclusions IPV is prevalent among women presenting for HIV care, and depressive symptoms or missed gynecological appointments should prompt further screening for IPV.

Intimate partner violence and engagement in HIV care and treatment among women

“…A total of 13 studies measured the association between IPV and at least one of the primary outcomes: ART uptake, ART adherence (self-report), ART adherence (viral suppression) and retention in HIV care. Table 1 presents the key characteristics and outcomes of the 13 included studies [25,[59][60][61][62][63][64][65][66][67][68][69][70]. Most studies (n ¼ 11) were conducted in the United States and sample sizes across all studies were relatively small, with a median of 234 participants.…”

“…As summarized in Table 1, several studies used brief, unvalidated screening tools to assess violence [59,[62][63][64]. Validated instruments included the Severity of Violence Against Women Scale [25,66] 12 months [59,66].…”

“…As summarized in Table 1, several studies used brief, unvalidated screening tools to assess violence [59,[62][63][64]. Validated instruments included the Severity of Violence Against Women Scale [25,66] 12 months [59,66]. Although several other articles included measures of recent violence (past 12 months [61,68]; past 5 months [63]), the authors did not conduct analysis using the 'recent violence' data.…”

“…to assess ART use at the time of interview [60,63,67]. Two assessed current ARTuse via clinical data routinely collected in the HIV clinic [59,65].…”

Substance Abuse, Violence, and HIV/AIDS (SAVA) Syndemic Effects on Viral Suppression Among HIV Positive Women of Color

“…4,5 These factors may negatively affect health outcomes in myriad ways, including decreased engagement in HIV care, 6 and reduced adherence to medications. 7,8 An estimated 8% of HIV-positive people in the US abuse alcohol, 9,10 while onethird of HIV patients receiving care report active drug use.…”