The impact of intimate partner violence on PrEP adherence among U.S. Cisgender women at risk for HIV

Autor: Katherine M. Anderson, Jill Blumenthal, Sonia Jain, Xiaoying Sun, K. Rivet Amico, Raphael Landovitz, Christine M. Zachek, Sheldon Morris, David J. Moore, Jamila K. Stockman
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Public Health, Vol 24, Iss 1, Pp 1-10 (2024)
Druh dokumentu: article
ISSN: 1471-2458
DOI: 10.1186/s12889-024-18946-4
Popis: Abstract Background Cisgender women account for 1 in 5 new HIV infections in the United States, yet remain under-engaged in HIV prevention. Women experiencing violence face risk for HIV due to biological and behavioral mechanisms, and barriers to prevention, such as challenges to Pre-Exposure Prophylaxis for HIV Prevention (PrEP) adherence. In this analysis, we aim to characterize intimate partner violence (IPV) among cisgender heterosexual women enrolled in a PrEP demonstration project and assess the associations with PrEP adherence. Methods Adherence Enhancement Guided by Individualized Texting and Drug Levels (AEGiS) was a 48-week single-arm open-label study of PrEP adherence in HIV-negative cisgender women in Southern California (N = 130) offered daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). From 6/2016 to 10/2018, women completed a survey reporting HIV risk behavior and experiences of any IPV (past 90-days) and IPV sub-types (past-year, lifetime) and biological testing for HIV/STIs at baseline, and concentrations of tenofovir-diphosphate (TFV-DP) in dried blood spots at weeks 4, 12, 24, 36, and 48. Outcomes were TFV-DP concentrations consistent with ≥ 4 or ≥ 6 doses/week at one or multiple visits. Multivariable logistic regression models were conducted to examine associations. Results Past-90-day IPV was reported by 34.4% of participants, and past-year and lifetime subtypes reported by 11.5-41.5%, and 21.5-52.3%, respectively. Women who engaged in sex work and Black women were significantly more likely to report IPV than others. Lifetime physical IPV was negatively associated with adherence at ≥ 4 doses/week at ≥ 3 of 5 visits, while other relationships with any IPV and IPV sub-types were variable. Conclusion IPV is an indication for PrEP and important indicator of HIV risk; our findings suggest that physical IPV may also negatively impact long-term PrEP adherence. Clinical Trials Registration NCT02584140 (ClinicalTrials.gov), registered 15/10/2015.
Databáze: Directory of Open Access Journals
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