Intimate Partner Violence and Oral HIV Pre-exposure Prophylaxis Adherence among Young African Women

Citation

Giovenco, Danielle; Pettifor, Audrey E.; Powers, Kimberly A.; Hightow-Weidman, Lisa B.; Pence, Brian W.; Celum, Connie; Delany-Moretlwe, Sinead; Hosek, Sybil; Donnell, Deborah; & Anderson, Peter L., et al. (2022). Intimate Partner Violence and Oral HIV Pre-exposure Prophylaxis Adherence among Young African Women. AIDS, 36(8), 1151-1159. PMCID: PMC9486991

Abstract

OBJECTIVE: To estimate the effect of intimate partner violence (IPV) on oral pre-exposure prophylaxis (PrEP) adherence among adolescent girls and young women (AGYW).
DESIGN: We conducted a secondary analysis of data from HIV Prevention Trials Network 082 (HPTN 082), a multisite prospective study designed to assess oral PrEP adherence among AGYW in southern Africa.
METHODS: We estimated the relative prevalence of high PrEP adherence 3 and 6 months after initiation among AGYW 16-25 years who reported a history of any IPV in the past year at enrollment versus AGYW who did not, both overall and by age. High adherence was defined as an intracellular tenofovir-diphosphate concentration at least 700 fmol/punch or more dried blood spots.
RESULTS: Among 409 PrEP-initiating AGYW, half (49%) reported experiencing any IPV by a current/recent partner in the year prior to enrollment. Overall, a similar proportion of AGYW who reported IPV had high PrEP adherence at months 3 and 6 as AGYW who did not report IPV. There was, however, evidence of effect modification by age at month 3: among AGYW less than 21 years old, those who reported IPV were less than half as likely to have high adherence [adjusted PR (aPR) = 0.43, 95% confidence interval (CI) 0.22-0.86]; among AGYW aged 21 years or older, those who reported IPV were more than twice as likely to have high adherence (aPR = 2.21, 95% CI 1.34-3.66). At month 6, effect estimates within each age stratum were consistent in direction to those at month 3.
CONCLUSION: IPV events may either impede or motivate PrEP adherence among African AGYW, with age appearing to be an important consideration for IPV-related adherence interventions.

URL

http://dx.doi.org/10.1097/qad.0000000000003216

Reference Type

Journal Article

Year Published

2022

Journal Title

AIDS

Author(s)

Giovenco, Danielle
Pettifor, Audrey E.
Powers, Kimberly A.
Hightow-Weidman, Lisa B.
Pence, Brian W.
Celum, Connie
Delany-Moretlwe, Sinead
Hosek, Sybil
Donnell, Deborah
Anderson, Peter L.
Mgodi, Nyaradzo
Bekker, Linda-Gail

Article Type

Regular

PMCID

PMC9486991

Data Set/Study

HIV Prevention Trials Network (HPTN)

Continent/Country

Africa

Sex/Gender

Women

ORCiD

Pettifor - 0000-0002-3387-0817