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Introduction
Intimate Partner Violence (IPV) is linked to low engagement with HIV management services
and adverse clinical outcomes, including poor ART adherence. In sub-Saharan Africa, stud-
ies on pregnant/postpartum women and transactional sex workers have produced divergent
evidence regarding IPV’s association with poor ART adherence. We investigate this associ-
ation among a broad group of women.
Methods
We sampled 408 HIV-positive women receiving free ART from different types of HIV clinics
at government health facilities, assessing for IPV exposure by a current partner, ART adher-
ence rate, and other factors that affect ART adherence (e.g. education, disclosure). ART
adherence rates were measured using the Visual Analogue Scale (VAS); responses were
dichotomised at a �95% cut-off. Multiple logistic regression models assessed the associa-
tion between the independent variables and ART adherence.
Results
The participants’ mean age was 38.6 (range: 18–69 years). The majority had ever attended
school (94%, n = 382), were in monogamous marriages (70%, n = 282), and had disclosed
status to partners (94%, n = 380). Overall, 60% (n = 242) reported optimal ART adherence
(� 95%) in the previous 30 days. The prevalence of IPV by the current partner was 76%
(CI95 = 72–80%). Experiencing physical IPV (AOR 0.57, CI95: 0.34–0.94, p = .028), sexual
IPV (AOR 0.50, CI95: 0.31–0.82, p = .005), or controlling behaviour (AOR 0.56, CI95: 0.34–
0.94, p = .027) reduced the odds of achieving optimal adherence, while a higher education
level and having an HIV-positive partner increased the odds.Conclusion
IPV is common and is associated with suboptimal ART adherence rates among a broad
group of HIV-positive women. ART programs could consider incorporating basic IPV inter-
ventions into regular clinic services to identify, monitor and support exposed women, as
they might be at risk of poor ART adherence. Still, there is need for more research on how
IPV affects ART adherence. |
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