Amsterdam 2015
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| Abstract #3446 - Challenging situations | ||||
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Session: 53.6: Challenging situations (Parallel) on Friday @ 11.00-12.30 in C002 Chaired by Heidi van Rooyen, Rich Wolitski Authors: Presenting Author: Mrs Abigail Hatcher - University the Witwatersrand, South Africa |
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| Additional Authors: | ||||
| Aim: Despite increased evidence for the effect of intimate partner violence (IPV) on HIV risk, little is known about how IPV influences the health of women already living with HIV/AIDS. Understanding IPV and engagement in HIV care is essential if programs are to protect the health of HIV-positive women. We aimed to estimate the odds of engagement in HIV care and treatment among HIV-positive women reporting intimate partner violence (IPV). | ||||
| Method / Issue: We systematically reviewed the literature on the association between IPV and engagement in care. Data sources included searches of electronic databases (PubMed, Web of Science, CINAHL, and PsychoInfo), hand searches, and citation tracking. Two reviewers screened 757 full-text papers, extracted data, and independently appraised study quality. Included studies were peer-reviewed and assessed IPV alongside engagement in care outcomes: antiretroviral treatment (ART) use self-reported ART adherence viral suppression retention in HIV care. Odds ratios (OR) were pooled using random effects meta-analysis. | ||||
| Results / Comments: Thirteen cross-sectional studies among HIV-positive women were included. Measurement of IPV varied, with most studies defining a 'case' as any history of physical and/or sexual IPV. Meta-analysis of five studies showed IPV to be significantly associated with lower ART use (OR=0.79, 95%CI 0.64-0.97). IPV was associated with poorer self-reported ART adherence in six studies (OR=0.48, 95%CI 0.30-0.75) and lower odds of viral load suppression in seven studies (OR=0.64, 95%CI 0.46-0.90). Lack of longitudinal data and measurement considerations should temper interpretation of these results. | ||||
| Discussion: IPV is associated with lower ART use, half the odds of self-reported ART adherence, and significantly worsened viral suppression among women. To ensure the health of HIV-positive women, it is essential for clinical programs to address conditions that impact engagement in care and treatment. IPV is one such condition, and its association with declines in ART use and adherence requires urgent attention. | ||||
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