Intimate Partner Violence and Adherence to HIV Pre-Exposure Prophylaxis (PrEP) in African Women in HIV Serodiscordant Relationships: A Prospective Cohort Study

December 2016 - Structural Prevention

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Roberts, S.T., Haberer, J., Celum, C., et al. Journal of Acquired Immune Deficiency Syndromes (November 2016), 73(3): 313–322.

This study examined the impact of intimate partner violence (IPV) on PrEP adherence among 1,785 women participating in a clinical trial. The authors conducted monthly in-person interviews during routine risk reduction counseling to assess IPV incidence; and assessed adherence through pill counting and testing serum tenofovir PrEP levels. Results showed that 16.1 percent of women reported experiencing IPV in the course of 437 interviews. The majority (68.8%) reported one IPV incident, but nearly 5 percent reported experiencing five or more. The most common IPV type was verbal, followed by physical and economic IPV. Women who experienced IPV were less likely to report recent sex, but more likely to report condomless sex, and that their partner had other sexual partners. Women who experienced IPV in the past three months were 50 percent more likely to have reduced PrEP adherence. No significant associations were found between HIV incidence and experiencing IPV in the past three months. Women reporting IPV explained that emotional trauma or fleeing to safety led to forgetting to take pills, or that their partner threw away their pills. PrEP projects that work with women who experience IPV should collect data to understand the impact of IPV on adherence in this group.

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