Citation

Siemieniuk RA, Krentz HB, Miller P, Woodman K, Ko K, Gill MJ. J. Acquir. Immune Defic. Syndr. (LWW) 2013; 64(1): 32-38.

Affiliation

1Southern Alberta HIV Clinic, Calgary, AB, Canada 2University of Toronto, Toronto, ON, Canada 3University of Calgary, Calgary, AB, Canada 4Mount Royal University, Calgary, AB, Canada 5End Abuse Canada, Edmonton, AB, Canada.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/QAI.0b013e31829bb007

PMID

23714742

Abstract

INTRODUCTION:: Intimate partner violence (IPV) is associated with increased risk of HIV infection among women, however whether IPV affects outcomes after HIV infection is uncertain. We assess the impact of IPV on HIV-positive women. METHODS:: All HIV-positive women who received outpatient HIV care in southern Alberta between March 2009 and January 2012 were screened for IPV. The associations with IPV of sociodemographic factors, health related quality of life, clinical status, and hospitalizations were obtained from a regional database and evaluated with multivariable regression analysis. RESULTS:: Of 339 women screened, 137 (40.4%) reported experiencing IPV. Those disclosing IPV had higher rates of:[Black Square] smoking [adjusted prevalence ratio (APR)=5.07; 95% confidence interval = 2.72-9.43];[Black Square] illicit drug use (APR=7.58, 2.45-23.26);[Black Square] a history of incarceration (APR=4.84, 1.85-12.68);[Black Square] depression (APR=2.50, 1.15-5.46); and,[Black Square] anxiety disorders (APR=5.75, 2.10-15.63).Health related quality of life was diminished with IPV (APR=2.94, 1.40-6.16) for poor/fair vs. very good/excellent. IPV-exposed women were hospitalized 256 times /1000 patient-years compared to 166/1000 patient-years among IPV-unexposed (P<0.001). The relative risk was increased for HIV-unrelated hospitalizations (1.42, 1.16-1.73) and for HIV-related hospitalizations after outpatient HIV care was initiated (2.19, 1.01-4.85). Modifiable contributors to the poor outcomes included decreased use of antiretroviral therapy (APR=0.55, 0.34-0.91) and additional interruptions in care longer than one year (APR=1.90, 1.07-3.39). CONCLUSIONS:: IPV is associated with deleterious HIV-related and HIV-unrelated health outcomes, of which suboptimal engagement in care is a contributor. To improve outcomes, practitioners should aim to increase engagement in care of these women in particular.

Language: en