HIV-infected women who do and do not report intimate partner violence: Viral replication and adherence to antiretroviral medications

Accounting for one-half of all new infections worldwide, women are the fastest growing group newly infected with HIV. Intimate partner violence affects 50% or more women worldwide with associated effects on morbidity and mortality. An intersection between HIV infection and intimate partner violence among women has been established. Yet research specifying the associated health effects of the intersection is lacking. No published studies examining the relationship between intimate partner violence, viral replication and adherence to antiretroviral medications among HIV-infected women were identified.

This research examined antiretroviral adherence and viral replication among HIV-infected women who did and did not report intimate partner violence. This non-experimental, comparative descriptive study recruited 272 HIV-infected women who had received health care for the previous 12 months at a publically-funded HIV specialty clinic. Participants were interviewed using the Severity of Violence Against Women Scale (SVAWS), the Danger Assessment (DA) and the Domestic Violence Specific Morisky Medication Adherence Scale. Viral load values were obtained by medical record abstraction.

The first hypothesis, that HIV-infected women who reported intimate partner violence would have lower adherence scale scores compared to women who did not report violence in the previous 12 months, was tested using the t test for independent samples. Fisher's Exact test was used for testing the second hypothesis that HIV-infected women who reported intimate partner violence in the past 12 months would have a greater proportion of detectable viral replication compared to women who did not report intimate partner violence. Hypotheses three and four, that SVAWS and DA total scores would be inversely correlated with medication adherence scores, were tested with Pearson's r correlations. Analyses found HIV-infected women who reported intimate partner violence in the past 12 months had significantly lower adherence scores t(262.1) = 4.91, p < .001) and significantly greater proportions of detectable viral replication compared to women who did not report intimate partner violence (Fisher's Exact p <.001). No significant associations were found between total SVAWS and DA scores and the adherence scores of the HIV-infected women who reported intimate partner violence in the past 12 months.