@article{ref1,
title="Interpersonal violence and other social-structural barriers associated with needing HIV treatment support for women living with HIV",
journal="Journal of interpersonal violence",
year="2021",
author="Magagula, Patience and Deering, Kathleen on behalf of the SHAWNA Project and Kestler, Mary and Pick, Neora and Ratzlaff, Andrea and Braschel, Melissa and Ranville, Flo and Shannon, Kate and Erickson, Margaret",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Women living with HIV (WLWH), experience disproportionate rates of violence, along with suboptimal HIV health outcomes, despite recent advancements in HIV treatment,  known as antiretroviral therapy (ART). The objectives of this study were to: (a)  describe different types of support needed to take ART and (b) investigate the  social and structural correlates associated with needing support for ART adherence  among WLWH. Data are drawn from Sexual health and HIV/AIDS: Women's Longitudinal  Needs Assessment, a community-based open research cohort with cisgender and  transgender WLWH, aged 14+ who live or access HIV services in Metro Vancouver,  Canada (2014-present). Baseline and semi-annual questionnaires are administered by  community interviewers alongside a clinical visit with a sexual health research  nurse. Bivariate and multivariable logistic regression using generalized estimating  equations and an exchangeable working correlation matrix was used to model factors  associated with needing supports for ART adherence. Among 276 WLWH, 51% (n = 142)  reported needing support for ART adherence; 95% of participants reported lifetime  gender-based violence and identified many interpersonal, structural, community, and  clinical supports that would facilitate and support ART adherence. In multivariable  logistic regression, participants who were Indigenous (adjusted odds ratio [AOR]:  1.70, 95% confidence intervals [CI]: 1.07-2.72), or otherwise racialized (AOR: 2.36,  95% CI : 1.09-5.12) versus white, experienced recent gender-based physical violence  (AOR : 1.54, 95% CI : 1.03-2.31), lifetime post-traumatic stress disorder (AOR :  1.97, 95% CI : 1.22-3.18), and recent illicit drug use (AOR : 2.15, 95% CI :  1.43-3.22), had increased odds of needing support for ART adherence. This research  suggests a need for trauma-informed, culturally safe and culturally responsive  practice and services for WLWH along the HIV care continuum to support ART  adherence. All services should be developed by, with, and for WLWH and tailored  according to gender identity, taking into account history, culture, and trauma,  including the negative impacts of settler colonialism for Indigenous people.<p /> <p>Language: en</p>",
language="en",
issn="0886-2605",
doi="10.1177/0886260520983257",
url="http://dx.doi.org/10.1177/0886260520983257"
}