TY - JOUR
T1 - In the era of universal test and treat in Uganda, recent intimate partner violence is not associated with subsequent ART use or viral suppression
T2 - Intimate Partner Violence and HIV Care Outcomes
AU - Miller, Amanda P.
AU - Pitpitan, Eileen V.
AU - Kiene, Susan M.
AU - Raj, Anita
AU - Jain, Sonia
AU - Zúñiga, María Luisa
AU - Nabulaku, Dorean
AU - Nalugoda, Fred
AU - Ssekubugu, Robert
AU - Nantume, Betty
AU - Kigozi, Godfrey
AU - Sewankambo, Nelson K.
AU - Kagaayi, Joseph
AU - Reynolds, Steven J.
AU - Wawer, Maria
AU - Wagman, Jennifer A.
N1 - Funding Information:
This work was supported by National Institutes of Health under grants F31AA028198-01, K01AA024068, R01DA042666, 5R01HD072695, R01AI114438, 5U2GGH000817 and in part by the Division of Intramural Research National Institute of Allergy and Infectious Diseases.
Publisher Copyright:
© 2023 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023
Y1 - 2023
N2 - Intimate partner violence (IPV) has been associated with delays throughout the HIV care continuum. This study explored prospective associations between experiences of past-year IPV and two HIV care outcomes in the context of current universal test and treat guidelines using two consecutive rounds of an ongoing HIV surveillance study conducted in the Rakai region of Uganda. Longitudinal logistic regression models examined associations between IPV, use of antiretroviral therapy (ART) and viral load suppression (VS), adjusting for outcome variables at baseline. To address differences in ART retention by IPV, propensity scores were used to create inverse-probability-of-treatment-and-censoring-weighted (IPTCW) models. At baseline, of 1923 women with HIV (WWH), 34.6%, 26.5%, 13.5% reported past-year verbal, physical and sexual IPV; a lower proportion of persons who experienced physical IPV (79.4%) were VS than those who did not (84.3%; p = 0.01). The proportion VS at baseline also significantly differed by exposure to verbal IPV (p = 0.03). However, in adjusted longitudinal models, IPV was not associated with lower odds of ART use or VS at follow-up. Among WWH in the Rakai region, IPV does not appear to be a barrier to subsequent ART use or VS. However, given the prevalence of IPV in this population, interventions are needed.
AB - Intimate partner violence (IPV) has been associated with delays throughout the HIV care continuum. This study explored prospective associations between experiences of past-year IPV and two HIV care outcomes in the context of current universal test and treat guidelines using two consecutive rounds of an ongoing HIV surveillance study conducted in the Rakai region of Uganda. Longitudinal logistic regression models examined associations between IPV, use of antiretroviral therapy (ART) and viral load suppression (VS), adjusting for outcome variables at baseline. To address differences in ART retention by IPV, propensity scores were used to create inverse-probability-of-treatment-and-censoring-weighted (IPTCW) models. At baseline, of 1923 women with HIV (WWH), 34.6%, 26.5%, 13.5% reported past-year verbal, physical and sexual IPV; a lower proportion of persons who experienced physical IPV (79.4%) were VS than those who did not (84.3%; p = 0.01). The proportion VS at baseline also significantly differed by exposure to verbal IPV (p = 0.03). However, in adjusted longitudinal models, IPV was not associated with lower odds of ART use or VS at follow-up. Among WWH in the Rakai region, IPV does not appear to be a barrier to subsequent ART use or VS. However, given the prevalence of IPV in this population, interventions are needed.
KW - HIV
KW - Uganda
KW - intimate partner violence
KW - treatment adherence
KW - viral suppression
UR - http://www.scopus.com/inward/record.url?scp=85159104242&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85159104242&partnerID=8YFLogxK
U2 - 10.1080/09540121.2023.2206092
DO - 10.1080/09540121.2023.2206092
M3 - Article
C2 - 37170392
AN - SCOPUS:85159104242
SN - 0954-0121
VL - 35
SP - 1291
EP - 1298
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
IS - 9
ER -