Three times as likely for women who experience intimate partner violence to have HIV

HSININI

7 Jan, 2023

According to a recent study done by McGill University experts, women who have recently experienced IPV are three times more likely to get HIV. Women in places like Sub-Saharan Africa deal with an epidemic of HIV and intimate partner abuse.

According to Professor Mathieu Maheu-Giroux, a Canada Research Chair in Population Health Modeling at McGill University, "more than one in four women experience intimate partner abuse in their lifetime globally."

"Sub-Saharan Africa is one of the continents with the highest rates of HIV and IPV worldwide. We sought to look at how recent HIV infections and women's access to care in this area were affected by intimate partner violence," he says.

Their study, which was published in The Lancet HIV, demonstrates the significant correlation between the HIV epidemic and violence against women in some of the most heavily affected nations. Women with HIV who had experienced intimate partner violence had a 9% lower chance of achieving viral load suppression, the last stage of HIV treatment.

There are new calls to stop all types of gender-based and sexual violence.

The Political Declaration on HIV and AIDS, which included ambitious new global targets for 2025, was adopted by the UN General Assembly in 2021, with the participation and cooperation of the Canadian government. This includes a dedication to ending IPV and all other forms of sexual and gender-based violence, which are major contributors to the HIV epidemic. To fulfill this pledge, we must increase our knowledge of the connections between IPV and HIV, according to Professor Maheu-Giroux.

The study team discovered that recent HIV infection and less frequent viral load suppression were both related to physical or sexual intimate partner abuse in the previous year. The researchers found that IPV might make it more difficult for women to get treated for HIV and to continue receiving care while they are infected.

According to Salome Kuchukhidze, a Ph.D. candidate in epidemiology and the study's lead author, "it is vital to stop the mutually reinforcing dangers of IPV and HIV on women's health and well-being given the high burden of IPV worldwide, including in Canada."

A pooled analysis of nationally representative surveys conducted in sub-Saharan Africa examined the impact of intimate partner violence on women's risk of contracting HIV and participation in the HIV treatment and care cascade.

Background

To stop the HIV pandemic and reach the 95-95-95 targets for HIV diagnosis, treatment, and viral load suppression, structural disparities such as intimate partner violence must be eliminated (IPV). The prevalence of IPV and HIV is highest in Sub-Saharan Africa. We set out to investigate how IPV affected recent HIV infections and women's participation in the HIV care continuum in sub-Saharan Africa.

Methods

From January 1, 2000, through December 31, 2020, we conducted a retrospective pooled analysis of data from nationally representative, cross-sectional surveys containing information on physical or sexual IPV (or both), and HIV testing. Relevant surveys, such as the Demographic and Health Survey, the AIDS Indicator Survey, the Population-based HIV Impact Assessment, and the South Africa National HIV Prevalence, Incidence, Behavior, and Communication Survey were found in data catalogs and earlier comprehensive assessments. All female respondents who were ever partners (married, divorced, or cohabiting) and who were 15 years of age or older were included in the individual-level data. To determine the association between past-year sexual or physical IPV (or both), as the primary exposure, and the prevalence ratios (PRs), we employed Poisson regression. and most recent HIV infection, as determined by recency assays, as the main result. We also looked at links between IPV in the previous year and self-reported HIV testing, antiretroviral treatment (ART) uptake, and viral load suppression at the time of the survey. Models were modified to account for survey-level fixed effects, participant age, age of sexual debut (HIV recency analysis), urban or rural domicile, relationship status, and education

Findings

57 studies including 280 259 ever-partnered women aged 15 to 64 years old that collected information on self-reported HIV testing and physical or sexual IPV in the previous year were available from 30 countries. In the previous year, 59 456 (21.2%) women reported engaging in physical or sexual IPV. Seven surveys provided information on ART uptake and viral load suppression, while six included information on recent HIV infection. The crude PR for recent HIV infection in women who had engaged in physical or sexual IPV during the previous year, compared to those who had not, was 351 (95% CI 164-751; n = 19 179). The PR after adjustment was 322 (151–85). In both the crude analysis (PR 097 [096-098]; n=274 506) and the adjusted analysis (adjusted PR 099 [098-101]), past-year physical or sexual IPV had a negligible impact on self-reported HIV testing in the previous year. Results for the relationship between ART uptake and prior IPV among women with HIV were unclear (crude PR 090 [085-096], adjusted PR 096 [090-102]; n=5629). (crude PR 085 [079-091], adjusted PR 091 [084-098], n=5627) Women with HIV who had experienced physical or sexual IPV in the previous year were less likely to achieve viral load suppression than those who had not.

Interpretation

Physical or sexual IPV during the previous year was linked to recent HIV infection and less frequent viral load suppression. While preventing IPV is always a must, getting rid of IPV might help put an end to the HIV epidemic.