TY - JOUR
T1 - Relationship between intimate partner violence and antiretroviral adherence and viral suppression in pregnancy
AU - Yee, Lynn M.
AU - Crisham Janik, Mary
AU - Dorman, Robin M.
AU - Chong, Phyllis S.
AU - Garcia, Patricia M.
AU - Miller, Emily S.
N1 - Funding Information:
LMY and ESM were supported by the NICHD K12 HD050121-11 and K12 HD050121-09, respectively, at the time of the study. RMD is supported by the Northwestern Memorial Foundation Evergreen Invitational Women's Health Initiative. PSC was funded by the HOPE Board at the time of the study.
Funding Information:
LMY and ESM were supported by the NICHD K12 HD050121-11 and K12 HD050121-09 , respectively, at the time of the study. RMD is supported by the Northwestern Memorial Foundation Evergreen Invitational Women’s Health Initiative . PSC was funded by the HOPE Board at the time of the study.
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/10
Y1 - 2018/10
N2 - Objective: To determine whether intimate partner violence (IPV) during pregnancy is associated with increased risk of clinical factors that influence maternal to child transmission (MTCT) of HIV. Study design: Retrospective cohort study of pregnant women living with HIV (WLHIV) who received prenatal care in a multidisciplinary perinatal HIV clinic (2007–2014). All women were assessed for IPV status during pregnancy by a social worker and/or health psychologist. Records were abstracted for obstetric information and factors associated with MTCT of HIV, including antenatal visit attendance, adherence to antiretroviral regimen, time until viral suppression after initiation of antiretroviral medications, HIV RNA at 36 weeks and at delivery, and preterm birth. Women who reported IPV were compared to those who did not using bivariable and multivariable logistic and linear regression analyses. Results: Of 215 women receiving care during the study period, 91.6% (N = 197) had documentation of IPV history. Of these women, 13.7% (N = 27) reported experiencing IPV during pregnancy. Women who reported IPV were less likely to be completely adherent to antiretroviral doses (38.5% vs. 62.0%, p = 0.039) and required significantly more time to achieve stable virologic suppression (16.0 vs. 8.5 weeks, p = 0.010). Time to achieve suppression remained significant in multivariable models (β 4.68, 95% CI 0.03–9.32). Conclusion: IPV during a pregnancy complicated by HIV appears to be associated with decreased antiretroviral adherence. Pregnant WLHIV who reported IPV exhibited delays in achieving virologic suppression. These women represent a vulnerable population who may require additional support and interventions to reduce the risk of MTCT of HIV.
AB - Objective: To determine whether intimate partner violence (IPV) during pregnancy is associated with increased risk of clinical factors that influence maternal to child transmission (MTCT) of HIV. Study design: Retrospective cohort study of pregnant women living with HIV (WLHIV) who received prenatal care in a multidisciplinary perinatal HIV clinic (2007–2014). All women were assessed for IPV status during pregnancy by a social worker and/or health psychologist. Records were abstracted for obstetric information and factors associated with MTCT of HIV, including antenatal visit attendance, adherence to antiretroviral regimen, time until viral suppression after initiation of antiretroviral medications, HIV RNA at 36 weeks and at delivery, and preterm birth. Women who reported IPV were compared to those who did not using bivariable and multivariable logistic and linear regression analyses. Results: Of 215 women receiving care during the study period, 91.6% (N = 197) had documentation of IPV history. Of these women, 13.7% (N = 27) reported experiencing IPV during pregnancy. Women who reported IPV were less likely to be completely adherent to antiretroviral doses (38.5% vs. 62.0%, p = 0.039) and required significantly more time to achieve stable virologic suppression (16.0 vs. 8.5 weeks, p = 0.010). Time to achieve suppression remained significant in multivariable models (β 4.68, 95% CI 0.03–9.32). Conclusion: IPV during a pregnancy complicated by HIV appears to be associated with decreased antiretroviral adherence. Pregnant WLHIV who reported IPV exhibited delays in achieving virologic suppression. These women represent a vulnerable population who may require additional support and interventions to reduce the risk of MTCT of HIV.
KW - HIV
KW - Human immunodeficiency virus
KW - Intimate partner violence
KW - Pregnancy
KW - Prevention of maternal-to-child transmission
KW - Vertical transmission
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UR - http://www.scopus.com/inward/citedby.url?scp=85047273494&partnerID=8YFLogxK
U2 - 10.1016/j.srhc.2018.05.001
DO - 10.1016/j.srhc.2018.05.001
M3 - Article
C2 - 30193723
AN - SCOPUS:85047273494
SN - 1877-5756
VL - 17
SP - 7
EP - 11
JO - Sexual and Reproductive Healthcare
JF - Sexual and Reproductive Healthcare
ER -
