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Women exposed to intimate partner violence are three times more likely to contract HIV

Women exposed to intimate partner violence are three times more likely to contract HIV

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Summary: A study reveals that women who have experienced domestic violence are three times more likely to contract HIV.

source: McGill University

Women who have experienced recent intimate partner violence (IPV) are three times more likely to contract HIV, according to a new study led by McGill University researchers. In regions such as sub-Saharan Africa, women face an intersecting epidemic of intimate partner violence and HIV.

“Globally, more than one in four women experience intimate partner violence in their lifetime,” said McGill University professor Matthew Maheu-Giroux, Canada Research Chair in Population Health Modelling.

“Sub-Saharan Africa is among one of the regions in the world with the highest prevalence of both IPV and HIV. We wanted to examine the effects of intimate partner violence on recent HIV infections and women’s access to HIV care in this region,” he says.

Their study, published in HIV Lancet, shows significant overlap between violence against women and the HIV epidemic in some of the most burdened countries. Among women living with HIV, those who had experienced intimate partner violence were nine percent less likely to achieve viral load suppression, the final step in HIV treatment.

New calls to end all forms of sexual and gender-based violence

“The 2021 UN General Assembly, attended and supported by the Government of Canada, adopted the Political Declaration on HIV and AIDS with bold new global goals for 2025. This includes a commitment to eliminate all forms of sexual violence and violence , including IPV, as a key factor in the HIV epidemic. Improving our understanding of the links between IPV and HIV is essential to meeting this commitment,” says Professor Maheu-Giroux.

Among women living with HIV, those who had experienced intimate partner violence were nine percent less likely to achieve viral load suppression, the final step in HIV treatment. Image is in the public domain

The researchers found that physical or sexual abuse by an intimate partner in the past year was associated with recent HIV infection and less frequent viral load suppression. According to the researchers, IPV may also create barriers for women in accessing HIV care and staying in care while living with the virus.

“Given the high burden of IPV worldwide, including in Canada, the need to stop the mutually reinforcing threats of IPV and HIV to women’s health and well-being is urgent,” says Salome Kuchuhidze, Ph.D. candidate studying epidemiology and lead author of the study.

For this research news on domestic violence and HIV

Author: Press office
source: McGill University
Contact: Press Office – McGill University
Image: Image is in the public domain

Original Research: Free access.
The effects of intimate partner violence on women’s risk of HIV infection and participation in the HIV treatment and care cascade: a pooled analysis of nationally representative studies in sub-Saharan Africa” by Salome Kuchukhidze et al. Lancet HIV


Summary

See also

Women exposed to intimate partner violence are three times more likely to contract HIV

The effects of intimate partner violence on women’s risk of HIV infection and participation in the HIV treatment and care cascade: a pooled analysis of nationally representative studies in sub-Saharan Africa

Background

Achieving the 95-95-95 targets for HIV diagnosis, treatment and viral load suppression to end the HIV epidemic depends on eliminating structural inequalities, including intimate partner violence (IPV). Sub-Saharan Africa has one of the highest prevalence rates of IPV and HIV in the world. We aimed to examine the effects of IPV on recent HIV infection and women’s engagement in the HIV care cascade in sub-Saharan Africa.

Methods

We performed a retrospective pooled analysis of data from nationally representative, cross-sectional studies with information on physical or sexual IPV (or both) and HIV testing from January 1, 2000 to December 31, 2020. Relevant studies were identified from data catalogs and previous large-scale reviews and included the Demographic and Health Survey, the AIDS Indicators Survey, the Population Impact Assessment of HIV and the South African National HIV Prevalence, Incidence, Behavior and Communication Survey. Individual-level data are included for all ever-partnered female respondents (currently or previously married or cohabiting) and aged 15 years or older. We used Poisson regression to estimate crude and adjusted prevalence ratios (PRs) for the association between past-year experience of physical or sexual IPV (or both), as the primary exposure, and recent HIV infection (measured by recency tests). , as the primary outcome. We also assessed the associations of past-year IPV with self-reported HIV testing (also in the past year) and antiretroviral therapy (ART) receipt and viral load suppression at the time of the study. Models were adjusted for participant age, age of sexual debut (HIV actuality analysis), urban or rural residence, partnership status, education, and study-level fixed effects.

Findings

57 studies with data on self-reported HIV testing and past-year physical or sexual IPV were available from 30 countries, covering 280,259 ever-partnered women, aged 15–64 years. 59,456 (21.2%) women experienced physical or sexual IPV in the past year. Six studies contained information on recent HIV infection and seven had data on ART uptake and viral load suppression. The crude PR for recent HIV infection among women who had experienced physical or sexual IPV in the past year versus those who had not was 3·51 (95% CI 1·64–7·51; n=19 179). Adjusted PR was 3·22 (1·51–6·85). Past-year physical or sexual IPV had a minimal effect on past-year self-reported HIV testing in a crude analysis (PR 0.97 [0·96–0·98]; n=274,506) and adjusted analysis (adjusted PR 0.99 [0·98–1·01]). Results were inconclusive about the association of ART receipt with past-year IPV among women living with HIV (crude PR 0.90 [0·85–0·96]adjusted PR 0·96 [0·90–1·02]; n=5629). Women living with HIV who had experienced physical or sexual IPV in the past year were less likely to achieve viral load suppression than those who had not experienced IPV in the past year (crude PR 0.85 [0·79–0·91]adjusted PR 0·91 [0·84–0·98]n=5627).

Interpretation

Physical or sexual IPV in the past year was associated with recent HIV infection and less frequent viral load suppression. Preventing IPV is inherently imperative, but eliminating IPV can contribute to ending the HIV epidemic.

Financing

Canadian Institutes of Health Research, the Canada Research Chairs Program and the Fonds de Recherche du Québec-Santé.


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