Citation

Mendoza C, Barrington C, Donastorg Y, Perez M, Fleming P, Decker M, Kerrigan D. J. Acquir. Immune Defic. Syndr. (LWW) 2016; 74(3): 273-278.

Affiliation

1Duke University School of Medicine 2University of North Carolina Gillings School of Global Public Health 3Instituto Dermatologico y Cirugia de la Piel 4University of Michigan School of Public Health 5The Johns Hopkins Bloomberg School of Public Health.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/QAI.0000000000001250

PMID

27861234

Abstract

BACKGROUND: Female sex workers (FSW) experience high rates of violence from their sexual partners. While violence is associated with HIV risk behaviors among FSW, there is limited evidence on the association between violence and HIV treatment outcomes.

METHODS: We analyzed data from a socio-behavioral survey with a cohort of FSW living with HIV in the Dominican Republic (n=268) to describe the burden of violence from a sexual partner in the last 6 months. We assessed the relationship between violence and HIV treatment outcomes, comparing findings across two types of sexual partners: intimate partners and clients.

RESULTS: Nearly one-fifth of women (18.3%) experienced violence in the last six months. More women experienced violence from an intimate partner (12.3%) than a client (8.3%), with some (2.6%) reporting both. While violence from an intimate partner was significantly associated with not currently being on ART (AOR: 4.05, 95% CI: 1.00-16.36), and missing an ART dose in the last 4 days (AOR: 5.26, 95% CI 1.91-14.53), violence from a client was associated with never having received HIV care (AOR: 2.85, 95% CI 1.03-7.92) and ever interrupting ART (AOR: 5.45, 95% CI 1.50-19.75).

CONCLUSIONS: Violence from a sexual partner is associated with poor HIV treatment outcomes among FSW. Different patterns by type of partner reflect how relationship dynamics may influence these associations. Violence prevention and support services should be tailored based on type of partner. Violence screening and referrals should be integrated into HIV care services for FSW to improve their health and reduce ongoing transmission.

Language: en