|
Abstract
|
BACKGROUND: Intimate partner violence (IPV) may impact on the HIV-treatment cascade. SETTING: Four high HIV-prevalence DREAMS health districts in South Africa.
METHODS: Secondary analysis of cross-sectional data collected March 2017-June 2018, using random household sample of young (12-24 years) girls and women. Face-to-face interviews assessed IPV and HIV-status knowledge, and finger-prick blood draws assessed ART uptake and viral suppression. We used logistic regression to estimate crude and adjusted effects of IPV on HIV knowledge, ART uptake, and viral suppression.
RESULTS: Of 18,230 adolescent girls and young women, 8,413 (46%) reported ever having had sex of whom 1118 (13%) were HIV-positive. The 90:90:90 benchmarks were: 61% knew their status, 86% had ART present in their blood sample, 91% were virally suppressed. Among the entire sample of young women living with HIV, 65.6% were virally suppressed. Past year IPV was reported by 15%. In adjusted models, IPV trended towards increasing the odds that a young woman was aware she was living with HIV (aOR=1.40, 2.00-9.98, p=0.067). There was no association between IPV and reduced treatment use (aOR=0.73, 0.41-1.29). IPV was independently associated with reduced viral suppression (aOR=0.30, 0.13-0.66).
CONCLUSIONS: Addressing the role of IPV in undermining the treatment cascade for adolescent and young women is a critical issue for HIV-programming.
Language: en |