Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia

Hampanda, Karen

doi:10.1016/j.socscimed.2016.02.011

Cited by 75 publications

(111 citation statements)

References 44 publications

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“…Women LWHA reported that CD4 machines were not working most of the time and could take a long time to be fixed; as a result, they were unable to test their CD4 counts, a measure which is very important for patient monitoring. This observation is in accordance with a systematic review in Malaysia, which showed that a lack of CD4 testing and delays in receiving CD4 results were contributing factors to HIV-positive patients becoming lost to care in SSA (19, 20). …”

Section: Discussionsupporting

confidence: 91%

Intimate partner violence and challenges facing women living with HIV/AIDS in accessing antiretroviral treatment at Singida Regional Hospital, central Tanzania

Kosia

Kakoko

Semakafu

et al. 2016

Global Health Action

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BackgroundHuman immunodeficiency virus (HIV) remains a global public health problem. Sub-Saharan Africa is the region most affected by HIV/AIDS in the world. Globally, and in Tanzania in particular, women are more affected by HIV/AIDS than men. Tanzania has been reported to be among the countries with the highest burden of intimate partner violence (IPV). This study explored the challenges facing women living with HIV/AIDS (LWHA) attending the care and treatment clinic (CTC) in Singida Regional Hospital in Tanzania.DesignA qualitative study was performed in which data were collected through in-depth interviews with 35 women LWHA who also experienced IPV. Content analysis was used to analyse the data.ResultsThe study findings showed that women LWHA experienced challenges from their male partners in the form of lack of fare to attend CTC, delayed attendance to CTC, verbal threats and intimidation, mistrust partner resulting in changed antiretroviral (ARV) dosing time. Also, systemic challenges such as malfunction of CD4 count testing apparatus contributed to mistrust from their male partners which led to IPV.ConclusionIn this study, women LWHA experienced IPV challenges that resulted in poor adherence to ARV medication and CTC attendance, as well as insufficient time to collect ARV medication. It is recommended that the government address systemic challenges faced by women LWHA, introduce multiple approaches to address the needs of women LWHA experiencing IPV, and develop strong policies to prevent IPV against women in Tanzania, regardless of their HIV status.

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Section: Discussionsupporting

confidence: 91%

Intimate partner violence and challenges facing women living with HIV/AIDS in accessing antiretroviral treatment at Singida Regional Hospital, central Tanzania

Kosia

Kakoko

Semakafu

et al. 2016

Global Health Action

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“…Notably, there was a significant interaction between female-directed emotional IPV, women’s participation in household decisions, and male partner controlling behaviors—with emotional IPV driving the relationship with uptake of infant HIV testing. Our findings add to the growing body of literature linking different forms of IPV to poor medical outcomes across the continuum of care for HIV-infected mothers and their children [19, 32–34]. Our findings also underscore the importance of examining IPV as a multidimensional phenomenon [35] and including emotional/psychological forms of abuse as potential predictors for poor health outcomes.…”

Section: Discussionsupporting

confidence: 58%

Barriers to uptake of early infant HIV testing in Zambia: the role of intimate partner violence and HIV status disclosure within couples

2017

Self Cite

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BackgroundEarly detection of pediatric HIV through uptake of infant HIV testing is critical for access to treatment and child survival. While structural barriers have been well described, a greater understanding of social and behavioral factors that may relate to maternal uptake of early infant HIV testing services is urgently needed. The aim of this study was to explore how gender power dynamics within couples affect HIV-positive women’s uptake of early infant HIV testing at a large health center in Lusaka, Zambia.MethodsIn 2014, 320 HIV-positive married postpartum women were recruited at a large public health facility in Lusaka to participate in a cross-sectional survey. Data on uptake of early infant HIV testing by 4–6 weeks of age was collected through medical records. Simple and multiple logistic regression models determined significant predictors of maternal uptake of early infant HIV testing.ResultsIn the adjusted model, uptake of early infant HIV testing was associated with female-directed emotional intimate partner violence (aOR 0.41; 95% CI 0.21–0.79; p < 0.01), HIV status disclosure to the male partner (aOR 13.73, 95% CI 3.59–52.49, p < 0.001), and maternal postpartum ART adherence (aOR 2.28, 95% CI 1.15–4.55, p < 0.05).ConclusionsDomestic relationship dynamics, including emotional violence and HIV status disclosure to the male partner, may play an important role in maternal uptake of early infant HIV testing. These findings provide additional evidence for the link between intimate partner violence against women and poor HIV-related health outcomes. Programs that adequately screen for and address various forms of intimate partner violence within the context of prevention of mother-to-child transmission are recommended.

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“…The original aim of the study was to explore the relationship between gender power dynamics and HIV-positive women’s adherence across the PMTCT cascade of care, including ART adherence during and after pregnancy [12], safe infant feeding [13], and pediatric HIV testing [14]. All of the participants from the parent study are included in our sub-analysis, which expands the previous work by exploring status disclosure to male partners as the outcome of interest.…”

Section: Methodsmentioning

confidence: 99%

HIV Status Disclosure Among Postpartum Women in Zambia with Varied Intimate Partner Violence Experiences

Hampanda

Rael

2017

AIDS Behav

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HIV-positive pregnant and postpartum women’s status disclosure to male sexual partners is associated with improved HIV and maternal and child health outcomes. Yet, status disclosure remains a challenge for many women living with HIV in sub-Saharan Africa, particularly those who are fearful of violence. The objective of the present study is to advance the current understanding of the relationship between intimate partner violence against women and their HIV status disclosure behaviors. We specifically evaluate how the severity, frequency, and type of violence against postpartum HIV-positive women affect status disclosure within married/cohabiting couples. A cross-sectional survey was administered by trained local research assistants to 320 HIV-positive postpartum women attending a large public health center for pediatric immunizations in Lusaka, Zambia. Survey data captured women’s self-reports of various forms of intimate partner violence and whether they disclosed their HIV status to the current male partner. Multiple logistic regression models determined the odds of status disclosure by the severity, frequency, and type of violence women experienced. Our findings indicate a negative dose-response relationship between the severity and frequency of intimate partner violence and status disclosure to male partners. Physical violence has a more pronounced affect on status disclosure than sexual or emotional violence. Safe options for women living with HIV who experience intimate partner violence, particularly severe and frequent physical violence, are urgently needed. This includes HIV counselors’ ability to evaluate the pros and cons of status disclosure among women and support some women’s decisions not to disclose.

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Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia

Cited by 75 publications

References 44 publications

Intimate partner violence and challenges facing women living with HIV/AIDS in accessing antiretroviral treatment at Singida Regional Hospital, central Tanzania

Intimate partner violence and challenges facing women living with HIV/AIDS in accessing antiretroviral treatment at Singida Regional Hospital, central Tanzania

Barriers to uptake of early infant HIV testing in Zambia: the role of intimate partner violence and HIV status disclosure within couples

HIV Status Disclosure Among Postpartum Women in Zambia with Varied Intimate Partner Violence Experiences

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