Intimate Partner Violence and Pre-exposure Prophylaxis (PrEP): A Rapid Review of Current Evidence for Women’s HIV Prevention

O’Malley, Teagen; Hawk, Mary; Egan, James E.; Krier, Sarah; Burke, Jessica G.

doi:10.1007/s10461-019-02743-x

Cited by 30 publications

(10 citation statements)

References 56 publications

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“…The South African government have implemented differentiated care models to address continued high HIV incidence among AGYW and ABYM, and the factors that increase their vulnerability to infection. PrEP has several advantages over other HIV prevention methods for women at high risk of contracting HIV including autonomous or covert use and not requiring use at the time of a sexual encounter [34,35]. Many factors contribute to lack of adherence and continuous use of PrEP among AGYW, including lack of knowledge, partner support, intimate partner violence (IPV), the need to conceal use, limited private storage space, fears of inadvertent disclosure, subsequent misperceptions about HIV serostatus, routine disruptions and not having a dose available [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

Strengthening health system’s capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS’Cap–PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa

et al. 2022

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Introduction Pre-exposure prophylaxis (PrEP) is an effective prevention intervention that can be used to control HIV incidence especially among people who are at increased risk for HIV such as adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM). In South Africa, various approaches of delivering PrEP have been adopted at different service delivery points (facility-based only, school-based only, community-based only and hybrid school-facility and community-facility models) to overcome challenges associated with individual, structural, and health systems related barriers that may hinder access to and uptake of PrEP among these populations. However, little is known about how to optimize PrEP implementation and operational strategies to achieve high sustained uptake of good quality services for AGYW and ABYM. This study aims to identify effective and feasible PrEP models of care for improving PrEP uptake, continuation, and adherence among AGYW and ABYM. Methods and analysis A sequential explanatory mixed-methods study will be conducted in 22 service delivery points (SDPs) in uMgungundlovu district, KwaZulu-Natal, South Africa. We will recruit 600 HIV negative, sexually active, high risk, AGYW (aged 15–24 years) and ABYM (aged 15–35 years). Enrolled participants will be followed up at 1-, 4- and 7-months to determine continuation and adherence to PrEP. We will conduct two focus group discussions (with 8 participants in each group) across four groups (i. Initiated PrEP within 1 month, ii. Did not initiate PrEP within 1 month, iii. Continued PrEP at 4/7 months and iv. Did not continue PrEP at 4/7 months) and 48 in-depth interviews from each of the four groups (12 per group). Twelve key informant interviews with stakeholders working in HIV programs will also be conducted. Associations between demographic characteristics stratified by PrEP initiation and by various service-delivery models will be assessed using Chi-square/Fishers exact tests or t-test/Mann Whitney test. A general inductive approach will be used to analyze the qualitative data. Ethics and dissemination The protocol was approved by the South African Medical Research Council Health Research Ethics Committee (EC051-11/2020). Findings from the study will be communicated to the study population and results will be presented to stakeholders and at appropriate local and international conferences. Outputs will also include a policy brief, peer-reviewed journal articles and research capacity building through research degrees.

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Section: Discussionmentioning

confidence: 99%

Strengthening health system’s capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS’Cap–PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa

et al. 2022

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“…In general PrEP awareness and acceptability among women has been limited, and even lower among women of color. A study analyzing knowledge and willingness to use PrEP among Black women showed that PrEP knowledge was 20% among the entire sample but was higher among high-risk participants than the rest of the sample (Ojikutu et al, 2018). Similarly, a qualitative study exploring PrEP acceptability among women in violent relationships demonstrated high interest in PrEP use (Braksmajer et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…For example, women who experienced sexual and psychological IPV were less likely to use PrEP compared to women who experience physical IPV (Hampanda, 2016), and a more recent study demonstrated that psychological IPV was associated with interest in using PrEP (Willie et al, 2018). Thus far, literature on PrEP research has mostly analyzed the composite variable of all three types of IPV with very few studies differentiating the influence of IPV type on PrEP uptake (Braksmajer et al, 2019;O'Malley et al, 2019;Roberts et al, 2016;. In addition, timing of IPV exposure may also influence PrEP uptake by shaping HIV risk perceptions among women depending on lifetime and past year experiences (Willie et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Understanding the Impact of Intimate Partner Violence Type and Timing on Pre-exposure Prophylaxis Knowledge, Acceptability, Sexual Behavior, and Gender Roles Among Women of Color

Villalba

Jean‐Gilles

Rosenberg

et al. 2021

J Interpers Violence

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Knowledge and acceptability are key factors for pre-exposure prophylaxis (PrEP) use among women with a history of intimate partner violence (IPV) and research suggests that different types of IPV affect PrEP uptake differently. Few studies have examined whether the type (i.e., physical, sexual, and psychological) and timing (i.e., lifetime, past year) of IPV experiences are related to PrEP knowledge and acceptability, or whether gender roles and sexual risk behaviors affect PrEP use. We aimed to examine the associations between lifetime and past-year physical, sexual, and psychological IPV experiences on PrEP-related outcomes (i.e., knowledge, acceptability, sexual behavior if on PrEP) and the association between gender roles and PrEP-related outcomes. A total of 186 women of color at risk for HIV participated in this study, of whom 54% had ever experienced partner violence. Results showed that lifetime psychological (OR 3.0, 95% CI 1.1–9.4) and lifetime physical IPV (OR 5.5, 95% CI 1.2–18.9) were significantly associated with increased PrEP knowledge. lifetime psychological (OR 6.3, 95% CI 1.0–13.6) and lifetime physical IPV (OR 4.3, 95% CI 4.3–11.5) were significantly associated with increased sexual behavior if on PrEP. Past year physical IPV was significantly associated with interest in using PrEP (OR 1.9, 95% CI 1.7–4.3) and with sexual behavior if on PrEP (OR 4.0, 95% CI 1.1–13.1). Being subordinate to others was also significantly associated with interest in using PrEP (OR 1.5, 95% CI 1.2–2.4) Self-silencing was significantly associated with increased sexual behavior if on PrEP (OR 1.2, 95% CI 1.0–1.5). Gender norms and IPV type and timing can influence whether a person is interested in PrEP use. Both lifetime and past-year IPV experiences need to be examined in the context of gender norms when prescribing PrEP to encourage uptake and continuation among vulnerable women at risk for HIV.

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“…This finding supports the critical need to promote pre-exposure prophylaxis (PrEP) among HIV-negative women who are survivors of sexual violence by an intimate partner. PrEP is a promising prevention strategy for abused women as it is an autonomous and discrete method that can be used prior to sexual activity (Braksmajer et al, 2016;Chen et al, 2011;Koechlin et al, 2017;O'Malley et al, 2019;Rubtsova et al, 2013). Although research is limited, evidence suggests that women who experience IPV, and pastyear IPV, demonstrate a greater likelihood of being interested in using PrEP (O'Malley et al, 2019;Rubtsova et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…PrEP is a promising prevention strategy for abused women as it is an autonomous and discrete method that can be used prior to sexual activity (Braksmajer et al, 2016;Chen et al, 2011;Koechlin et al, 2017;O'Malley et al, 2019;Rubtsova et al, 2013). Although research is limited, evidence suggests that women who experience IPV, and pastyear IPV, demonstrate a greater likelihood of being interested in using PrEP (O'Malley et al, 2019;Rubtsova et al, 2013). In Brazil, PrEP was approved for use in December 2017, but abused women are not included within the key populations of focus for PrEP roll-out and implementation (e.g., sex workers, men who have sex with men [MSM], transgender women) (Agência Nacional de Vigilância Sanitária [Anvisa]).…”

Section: Discussionmentioning

confidence: 99%

Typologies of violence against women in Brazil: A latent class analysis of how violence and HIV intersect

Tsuyuki

Stockman

Knauth

et al. 2020

Global Public Health

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We address the limited understanding around the overlap between violence and HIV in Brazil. Data was from two clinic-based samples of HIV-positive (n=1,534) and HIV-negative women (n=1,589) in São Paulo and Porto Alegre. We conducted latent class analysis and identified violence typologies by type of violence, life course timing, frequency, and perpetrator, stratified by city and HIV-status. Overall, HIV-positive women experienced more lifetime physical and sexual violence than HIV-negative women. Twelve unique violence latent classes were identified. In São Paulo, HIV-positive women were likely to have endured physical violence several times (Conditional Probability [CP]: 0.80) by an intimate partner (CP: 0.85), and sexual violence several times (CP: 0.46) by an intimate partner (CP: 0.62). In Porto Alegre, HIV-positive women endured physical violence several times (CP: 0.80) by an intimate partner (CP: 0.70) during childhood/ adolescence (CP: 0.48), and sexual violence several times (CP: 0.54) by an intimate partner (CP: 0.60). Findings inform interventions to educate around gender equity, violence, and the health

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Intimate Partner Violence and Pre-exposure Prophylaxis (PrEP): A Rapid Review of Current Evidence for Women’s HIV Prevention

Cited by 30 publications

References 56 publications

Strengthening health system’s capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS’Cap–PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa

Strengthening health system’s capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS’Cap–PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa

Understanding the Impact of Intimate Partner Violence Type and Timing on Pre-exposure Prophylaxis Knowledge, Acceptability, Sexual Behavior, and Gender Roles Among Women of Color

Typologies of violence against women in Brazil: A latent class analysis of how violence and HIV intersect

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