scholarly journals The relationship between intimate partner violence and HIV outcomes among pregnant women living with HIV in Malawi

2021 ◽  
Vol 33 (4) ◽  
pp. 242-252
Author(s):  
Elizabeth C. Wetzel ◽  
Tapiwa Tembo ◽  
Elaine J. Abrams ◽  
Alick Mazenga ◽  
Mike J. Chitani ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Psychosocial Factors ◽  
Partner Violence ◽  
Health Concern ◽  
Art Adherence ◽  
Global Public Health ◽  
Women Living With Hiv ◽  
Current Partner ◽  
Living With Hiv

BackgroundIntimate partner violence (IPV) is a global public health concern particularly in pregnancy where IPV can have negative health implications for the mother and child. Data suggest IPV disproportionately affects pregnant women living with HIV (PWLWH) compared to those without HIV. HIV-related outcomes are worse among women experiencing IPV. Despite this knowledge, there is paucity of data concerning PWLWH and IPV in Malawi, where there is a high HIV prevalence (10.6%). ObjectivesWe aim to characterize IPV amongst PWLWH in Malawi and describe its relationship to demographic characteristics, psychosocial factors, and HIV-related outcomes. MethodsThis analysis used data from the VITAL Start pilot study, which is a video-based intervention targeting retention and ART adherence amongst PWLWH in Malawi. PWLWH not on ART were recruited at antenatal clinic and given study questionnaires to assess demographics, IPV, and psychosocial factors. Questionnaires were also administered at one-month follow-up to assess outcomes related to HIV. Descriptive statistics and logistic regression models were used to explore the risk factors associated with IPV.ResultsThirty-nine percent of participants reported ever experiencing IPV from their current partner. The majority (53%) reporting IPV experienced more than one type of violence. IPV was associated with being married (p=0.04) and depression (p<0.0001) in the univariable analysis. For women retained at one-month, IPV was associated with reporting a missed ART dose in the past month but not with adherence measured by pill count.ConclusionsA large proportion of PWLWH experienced IPV from their current partner and IPV was associated with worse self-reported ART adherence at one-month follow-up. Further evidence is needed to understand how IPV impacts PWLWH throughout postpartum and beyond. Given the detrimental impact on health outcomes among PWLWH in Malawi, additional focus on IPV is essential to identify mechanisms to prevent, screen, and manage IPV among this population.

scholarly journals The syndemic effects of mental ill health, household hunger, and intimate partner violence on adherence to antiretroviral therapy among pregnant women living with HIV in Yaoundé, Cameroon

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246467
Author(s):  
Evette Cordoba ◽  
Angela M. Parcesepe ◽  
John A. Gallis ◽  
Jennifer Headley ◽  
Claudian Soffo ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Partner Violence ◽  
Common Mental Disorders ◽  
Intimate Partner ◽  
Art Adherence ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
The Relationship

Background This research advances understanding of interrelationships among three barriers to adherence to antiretroviral therapy (ART) among pregnant women living with HIV (WLWH) in Cameroon: probable common mental disorders (CMD), intimate partner violence (IPV), and hunger. Methods The sample included 220 pregnant WLWH in Cameroon. Multivariable modified Poisson regression was conducted to assess the relationship between IPV, hunger, and CMD on ART adherence. Results Almost half (44%) of participants recently missed/mistimed an ART dose. Probable CMD was associated with greater risk of missed/mistimed ART dose (aRR 1.5 [95% CI 1.1, 1.9]). Hunger was associated with greater risk of missed/mistimed ART dose among those who reported IPV (aRR 1.9 [95% CI 1.2, 2.8]), but not among those who did not (aRR 0.8 [95% CI 0.2, 2.3]). Conclusion Suboptimal ART adherence, CMD, and IPV were common among pregnant WLWH in Cameroon. Pregnant WLWH experiencing IPV and hunger may be especially vulnerable to suboptimal ART adherence.

Factors Associated with Postpartum Loss to Follow-Up and Detectable Viremia After Delivery Among Pregnant Women Living with HIV

2019 ◽  
Vol 33 (1) ◽  
pp. 14-20
Author(s):  
Emily H. Adhikari ◽  
Casey S. Yule ◽  
Scott W. Roberts ◽  
Vanessa L. Rogers ◽  
Jeanne S. Sheffield ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Loss To Follow Up ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals Prevention measures for vertical HIV transmission: monitoring infected pregnant women and exposed children

2021 ◽  
Vol 21 (1) ◽  
pp. 207-215
Author(s):  
Cristina Silvana da Silva Vasconcelos ◽  
Renata Junqueira Pereira ◽  
Adiléia Fernandes Barros da Silva Santos ◽  
Lúcia Helena Almeida Gratão
Keyword(s):  
Pregnant Women ◽  
Healthcare Service ◽  
Service Use ◽  
The State ◽  
Public Healthcare ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Living With Hiv

Abstract Objectives: to present an analysis of the follow-up of exposed children and pregnant women living with HIV who are assisted in a reference public healthcare service of a Brazilian capital. Methods: this is a cross-sectional study with sociodemographic and clinical data obtainedfrom physical and electronic medical records of women living with HIV and exposed children, treated between 2000 and 2018, in a secondary healthcare service. For associations, the chi-square test at 5% significance was used. Results: the data about 183 pregnancies and 214 children from the capital or other municipalities in the state were analyzed. The women have low schooling, are brown or black, single, multiparous, diagnosed with HIV during prenatal care, with the start of follow-up from the third trimester of pregnancy and the use of prophylaxis during childbirth. As for children, the associations were significant for notification on SINAN, admission to the health service, use of prophylaxis indicating better monitoring for those who live in the state capital. Conclusions: the prevention measures recommended by the Ministry of Health, in general, were followed, but children and pregnant women who live in other cities were worse off than those ones in the capital. Unnotified cases were identified on SINAN. These issues may contribute to new cases of vertical transmission of HIV.

scholarly journals Late antiretroviral refills and condomless sex in a cohort of HIV-seropositive pregnant and postpartum Kenyan women

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254767
Author(s):  
McKenna C. Eastment ◽  
John Kinuthia ◽  
Lei Wang ◽  
George Wanje ◽  
Katherine Wilson ◽  
...  
Keyword(s):  
Partner Violence ◽  
Postpartum Period ◽  
Hiv Treatment ◽  
Adjusted Relative Risk ◽  
Art Adherence ◽  
Condomless Sex ◽  
Women Living With Hiv ◽  
Kenyan Women ◽  
Living With Hiv ◽  
Hiv Seropositive

Introduction The postpartum period can be challenging for women living with HIV. Understanding how the postpartum period impacts ART adherence and condomless sex could inform the development of comprehensive sexual and reproductive health and HIV services tailored to the needs of women living with HIV during this critical interval. Methods In a longitudinal cohort study of HIV-seropositive Kenyan women, late ART refills and self-reported condomless sex were compared between the woman’s pregnancy and the postpartum period. Analyses were conducted using generalized estimating equations and adjusted for alcohol use, depressive symptoms, intimate partner violence (IPV), and having a recent regular partner. Effect modification was explored for selected variables. Results and discussion 151 women contributed visits. Late ART refills occurred at 7% (32/439) of pregnancy visits compared to 18% (178/1016) during the postpartum period (adjusted relative risk [aRR] 2.44, 95% confidence interval [CI] 1.62–3.67). This association differed by women’s education level. Women with ≥8 years of education had late ART refills more during the postpartum period than pregnancy (aRR 3.00, 95%CI 1.95–4.62). In contrast, in women with <8 years of education, late ART refills occurred similarly during pregnancy and the postpartum period (aRR 0.88, 95%CI 0.18–4.35). Women reported condomless sex at 10% (60/600) of pregnancy visits compared to 7% (72/1081) of postpartum visits (aRR 0.76, 95%CI 0.45–1.27). This association differed by whether women had experienced recent IPV. Women without recent IPV had a significant decline in condomless sex from pregnancy to postpartum (aRR 0.53, 95%CI 0.30–0.95) while women with recent IPV had no significant change in condomless sex from pregnancy to postpartum (aRR 1.76, 95%CI 0.87–3.55). Conclusion Improved support for ART adherence during the postpartum period and addressing IPV to limit condomless sex could improve HIV treatment and prevention outcomes for HIV-seropositive women as well as their infants and sexual partners.

scholarly journals Common mental disorders and intimate partner violence against pregnant women living with HIV in Cameroon: a cross-sectional analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angela M. Parcesepe ◽  
Evette Cordoba ◽  
John A. Gallis ◽  
Jennifer Headley ◽  
Berenger Tchatchou ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Partner Violence ◽  
Common Mental Disorders ◽  
Mental Health Disorders ◽  
Intimate Partner ◽  
Women Living With Hiv ◽  
Health Disorders ◽  
Living With Hiv ◽  
The Relationship

Abstract Background Women living with HIV are at increased risk of poor mental health and intimate partner violence (IPV). Mental health disorders have been consistently associated with suboptimal HIV-related outcomes. Little is known about the prevalence or correlates of mental health disorders among pregnant women living with HIV in sub-Saharan Africa. Methods This study assessed the prevalence of probable common mental disorders (CMD), i.e., depressive or anxiety disorders, and the relationship between probable CMD and recent IPV among pregnant women living with HIV in Cameroon. The sample included 230 pregnant women living with HIV aged > 18 enrolled in care at 10 HIV clinics in Cameroon. Probable CMD was assessed with the WHO Self Reporting Questionnaire (SRQ-20). Multivariable logistic regression was conducted to assess the relationship between IPV and probable CMD. Results Almost half (42%) of participants had probable CMD using a 7/8 cut-off of the SRQ-20. Emotional, physical, and sexual IPV were reported by 44, 37, and 31% of respondents, respectively. In multivariable regression analyses, all forms of IPV assessed were significantly associated with greater odds of probable CMD. Conclusions Pregnant women living with HIV in Cameroon had a high prevalence of probable CMD and IPV. Screening and services to address IPV and mental health are urgently needed for this population. Integrated interventions to both prevent and screen and address IPV and probable CMD should be developed, implemented, and evaluated.

scholarly journals Mapping the evidence of intimate partner violence among women living with HIV/AIDS in Africa: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029284 ◽  
Author(s):  
Mengistu Meskele ◽  
Nelisiwe Khuzwayo ◽  
Myra Taylor
Keyword(s):  
Intimate Partner Violence ◽  
Scoping Review ◽  
Full Text ◽  
Partner Violence ◽  
Grey Literature ◽  
Intimate Partner ◽  
Health Concern ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

IntroductionAmong women living with HIV, intimate partner violence (IPV) is increasingly recognised worldwide as a serious public health concern. The understanding of the link between IPV and HIV is currently inconclusive and information concerning the IPV experiences of HIV-infected women is insufficient. This protocol aims to map evidence of IPV against women living with HIV/AIDS in Africa.Methods and analysisWe will search and review peer-reviewed and review articles. The comprehensive search will include the electronic databases PubMed, MEDLINE with full text via EBSCO host, Google Scholar, Science Direct and Scopus. The advanced search will use MeSH terms. Grey literature will also be included. The titles of the studies from the database searches will be screened, and duplicates will be removed. The abstract screening will be done independently by two reviewers, followed by the full-text screening which will be based on the eligibility criteria. The six methodological stages in this review will be to: identify the research questions; identify relevant studies; select the studies; chart the data; collate, summarise and report the results; and thereafter undertake consultations. The quality of studies included in the review will be determined by the Mixed Methods Appraisal Tool. NVIVO software V.11 will be used to undertake a thematic analysis of each of the studies and to extract the relevant outcomes.DisseminationThe results of this study will be disseminated through publication, and presented at conferences related to IPV.Scoping review registrationCurrently, a scoping review is not eligible for registration on the International Prospective Register of Systematic Reviews.

Social Vulnerability among Foreign-Born Pregnant Women and Maternal Virologic Control of HIV

2020 ◽  
Author(s):  
Ashish Premkumar ◽  
Lynn M. Yee ◽  
Lia Benes ◽  
Emily S. Miller
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Median Time ◽  
Social Vulnerability ◽  
Viral Suppression ◽  
Foreign Born ◽  
Women Living With Hiv ◽  
Virologic Control ◽  
Clinical Records ◽  
Living With Hiv

Objective The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy. Study Design This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapy. Bivariable analyses were performed. Results A total of 111 foreign-born women were eligible for analysis, of whom 25 (23%) were classified as socially vulnerable. Social and clinical characteristics of women diverged by social vulnerability categorization but no differences reached statistical significance. On bivariable analysis, socially-vulnerable women were at increased risk for needing > 12 weeks to achieve viral suppression (relative risk: 1.78, 95% confidence interval: 1.18–2.67), though there was no association with missing ≥ 5 doses of antiretroviral therapy or median time to viral suppression after initiation of antiretroviral therapy. Conclusion Among foreign-born, pregnant women living with HIV, markers of virologic control during pregnancy were noted to be worse among socially-vulnerable women. Insofar as maternal viremia is the predominant driver of perinatal transmission, closer clinical surveillance and support may be indicated in this population. Key Points

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