Intimate Partner Violence and Self-Reported Pre-exposure Prophylaxis Interruptions Among HIV-Negative Partners in HIV Serodiscordant Couples in Kenya and Uganda

Background: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk. Demonstration projects conducted in diverse settings worldwide illustrate practical examples of how PrEP can be delivered. This manuscript presents estimates of effectiveness and patterns of PrEP use within a two-year demonstration project of PrEP for HIV-negative members of heterosexual HIV serodiscordant couples in East Africa. Methods: The PrEP delivery model integrated PrEP into HIV treatment services, prioritizing PrEP use for HIV-negative partners within serodiscordant couples before and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART). We measured PrEP uptake through pharmacy records and adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results: We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP. Ninety-seven percent of HIV-negative partners initiated PrEP. Objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected. Four incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services. Conclusions: PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV. Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

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Intimate partner violence is linked to less HIV testing uptake among high-risk, HIV-negative women in Atlanta

AIDS Care ◽

10.1080/09540121.2016.1271936 ◽

2016 ◽

Vol 29 (8) ◽

pp. 953-956 ◽

Cited By ~ 3

Author(s):

Ogechukwu Etudo ◽

Nicholas Metheny ◽

Rob Stephenson ◽

Ameeta S. Kalokhe

Keyword(s):

Intimate Partner Violence ◽

High Risk ◽

Hiv Testing ◽

Partner Violence ◽

Intimate Partner ◽

Testing Uptake ◽

Hiv Negative

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430Predictors of Intimate Partner Violence amongst WLWHA and HIV negative women in Umuahia

International Journal of Epidemiology ◽

10.1093/ije/dyab168.501 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Franklin Odini ◽

Uloaku Emma-Ukaegbu ◽

Uche Nwamoh

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Male Partner ◽

Cross Sectional Study ◽

Intimate Partner ◽

Cross Sectional ◽

Adolescent Women ◽

Prevention Interventions ◽

Partner Involvement ◽

Hiv Negative

Abstract Background Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. IPV is the commonest form of violence against women and one of the most pervasive human rights abuses against women. The UN reported that 1 in 3 women had experienced physical/sexual violence at some point in their lives and 2 in 3 victims of intimate partner homicide are women. This study is aimed at determining the predictors of IPV amongst WLWHA and HIV negative women in Umuahia, Nigeria. Methods A comparative cross-sectional study involving 200 WLWHA and 200 HIV negative women in Umuahia using systematic random sampling method. An interviewer-administered questionnaire was deployed for data collection. Data analysis was done using IBM SPSS. Results Predictors of IPV amongst WLWHA included partner involvement in concurrent relationship and having childhood exposure to domestic violence while those amongst HIV negative women included coerced first sex, woman earning more than her partner, partner frequent use of alcohol and partner use of either or both cigarette and marijuana. Conclusion Predictors of IPV differed amongst both groups of women. Primary prevention interventions aimed at prevention and reduction should be instituted especially amongst WLWHA. Health care settings should be equipped to ensure a comprehensive response whenever IPV is detected. Keywords Intimate Partner Violence, Predictors, WLWHA.

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Enhancing domestic violence advocates’ ability to discuss HIV pre-exposure prophylaxis (PrEP): Feasibility and acceptability of an educational intervention

Women s Health ◽

10.1177/17455065211070548 ◽

2022 ◽

Vol 18 ◽

pp. 174550652110705

Author(s):

Tiara C Willie ◽

Laurel Sharpless ◽

Mauda Monger ◽

Trace S Kershaw ◽

Wendy B Mahoney ◽

...

Keyword(s):

Domestic Violence ◽

Intimate Partner Violence ◽

Hiv Prevention ◽

Partner Violence ◽

Self Efficacy ◽

Intimate Partner ◽

Hiv Care ◽

Post Intervention ◽

Prevention Services ◽

Exposure Prophylaxis

Background: Survivors of intimate partner violence are at elevated risk for HIV acquisition, yet there is limited research on the best strategies to optimize biomedical HIV prevention, such as pre-exposure prophylaxis among this population. Domestic violence agencies are critical collaborating partners and function as potential entry points into HIV prevention services for survivors; however, limited knowledge regarding HIV prevention has been an important barrier to advocate-led discussions. This study aimed to develop, implement, and evaluate an HIV prevention intervention for domestic violence advocates. Setting: A nonrandomized, group-based intervention with pre-intervention, immediate post-intervention, and 3-month post-intervention periods were conducted with multiple domestic violence agencies in Mississippi. Methods: Overall, 25 domestic violence advocates participated in the two-session intervention. Surveys were administered to assess pre-exposure prophylaxis knowledge, self-efficacy, subjective norms, and willingness to provide HIV prevention services to intimate partner violence survivors. Generalized estimating equations were conducted to assess change in behavioral outcomes over time. Results: Compared to pre-intervention, there were significant increases at immediate and 3-month post-intervention in advocates’ intervention acceptability, pre-exposure prophylaxis knowledge, and self-efficacy to provide HIV prevention information, discuss pre-exposure prophylaxis eligibility criteria, assist pre-exposure prophylaxis-engaged clients, and initiate pre-exposure prophylaxis counseling. Conclusion: This group-based intervention enhanced domestic violence advocates’ acceptability, pre-exposure prophylaxis knowledge, and self-efficacy to offer HIV care information, discuss pre-exposure prophylaxis eligibility, assist pre-exposure prophylaxis-engaged survivors, and initiate pre-exposure prophylaxis counseling with intimate partner violence survivors. Efforts should focus on training domestic violence advocates in HIV prevention care for survivors and also include these agencies in collaborative strategies to reduce HIV incidence.

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Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa

Gates Open Research ◽

10.12688/gatesopenres.12752.1 ◽

2017 ◽

Vol 1 ◽

pp. 3 ◽

Cited By ~ 33

Author(s):

Renee Heffron ◽

Kenneth Ngure ◽

Josephine Odoyo ◽

Nulu Bulya ◽

Edna Tindimwebwa ◽

...

Keyword(s):

Hiv Infections ◽

Hiv Treatment ◽

Demonstration Project ◽

Open Label ◽

Serodiscordant Couples ◽

Treatment Services ◽

Hiv Serodiscordant Couples ◽

Exposure Prophylaxis ◽

Living With Hiv ◽

Hiv Negative

Introduction: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV. Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered. Methods: We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa. The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART). We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results: We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP. Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected. A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, p<0.0001) in HIV incidence, relative to estimated HIV incidence for the population in the absence of PrEP integrated into HIV treatment services. Conclusions: PrEP uptake and adherence were high and incident HIV was rare in this PrEP demonstration project for African HIV-negative individuals whose partners were known to be living with HIV. Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

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