Citation

Kidman R, Violari A. J. Acquir. Immune Defic. Syndr. (LWW) 2018; 77(1): 64-71.

Affiliation

a Program in Public Health and Department of Family, Population & Preventative Medicine, Stony Brook University, Health Sciences Center, Level 3, Stony Brook, NY 11794, USA b Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/QAI.0000000000001569

PMID

29040165

Abstract

BACKGROUND: As perinatal HIV-infected youth become sexually active, the potential for onward transmission becomes an increasing concern. In other populations, intimate partner violence (IPV) is a risk factor for HIV acquisition. We build on this critical work by studying the role of IPV in facilitating onward transmission among HIV-infected youth - an important step towards effective intervention. SETTING: Soweto, South Africa.

METHODS: Self-report surveys were completed by 129 perinatal HIV-infected female youth (aged 13-24). We calculated the IPV prevalence, and used logistic models to capture the association between IPV and health outcomes known to facilitate onward HIV transmission (e.g., risky sex, poor medication adherence, depression, substance abuse).

RESULTS: A fifth of perinatal HIV-infected participants reported physical and/or sexual IPV in the past year; a third reported lifetime IPV. Childhood adversity was common and positively associated with IPV. Past-year physical and/or sexual IPV was positively correlated with high risk sex (OR=8.96; 95% CI 2.78-28.90), pregnancy (OR=6.56; 95% CI 1.91-22.54), poor medication adherence to antiretroviral therapy (OR=5.37; 95% CI 1.37-21.08), depression (OR 4.25; 95% CI 1.64-11.00) and substance abuse (OR 4.11; 95% CI 1.42-11.86 respectively). Neither past-year nor lifetime IPV was associated with viral load or HIV status disclosure to a partner.

CONCLUSION: We find that IPV may increase risk for onward HIV transmission in perinatal HIV-infected youth by both increasing engagement in risky sexual behaviors and by lowering medication adherence. HIV clinics should consider integrating primary IPV prevention interventions, instituting routine IPV screening, and collocating services for victims of violence.

Language: en