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. 2018 Feb 1;77(2):154-159.
doi: 10.1097/QAI.0000000000001574.

Intimate Partner Violence and Self-Reported Pre-exposure Prophylaxis Interruptions Among HIV-Negative Partners in HIV Serodiscordant Couples in Kenya and Uganda

Alejandra Cabral, Jared M Baeten  1   2 , Kenneth Ngure  3 , Jennifer Velloza  1 , Josephine Odoyo  4 , Jessica E Haberer  5 , Connie Celum  1   2 , Timothy Muwonge  6 , Stephen Asiimwe  7 , Renee Heffron  1 ; Partners Demonstration Project Team
Affiliations

Intimate Partner Violence and Self-Reported Pre-exposure Prophylaxis Interruptions Among HIV-Negative Partners in HIV Serodiscordant Couples in Kenya and Uganda

Alejandra Cabral et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Oral pre-exposure prophylaxis (PrEP) is effective for HIV prevention, and PrEP delivery studies are investigating ways to deliver PrEP with high adherence. However, in many settings with high HIV burden, intimate partner violence (IPV) is reported often and could be a barrier to the effective PrEP use. We examined the association between IPV and interruptions in PrEP use.

Methods: We analyzed data from 1013 serodiscordant heterosexual couples enrolled in a large PrEP demonstration project in Kenya and Uganda, the Partners Demonstration Project. At quarterly study visits, HIV-negative participants receiving PrEP were asked about interruptions in their PrEP use and experiences with IPV. The association between IPV and PrEP interruptions was analyzed using multivariable generalized estimating equations.

Results: At baseline and follow-up, there were 53 visits with reports of abuse by 49 HIV-negative partners, including physical, economic, and verbal IPV. Interruptions in PrEP use were reported at 328 visits (7.1% of all visits) by 249 people. The median length of PrEP interruption was 28 days (interquartile range: 7-45). The frequency of PrEP interruptions among those reporting IPV was 23.8% and those without IPV was 6.9%. PrEP interruption was significantly associated with IPV after adjustment for age and frequency of sexual intercourse (adjusted odds ratio = 2.6, 95% confidence interval: 1.2 to 6.0).

Conclusions: IPV was more likely to be reported at visits when PrEP interruptions were also reported, which may have implications for sustained adherence to PrEP. Within PrEP delivery programs, there may be opportunities to assess individual safety and well-being to bolster adherence.

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Figures

Figure 1
Figure 1. Types of IPV reports in visits 53 by 49 women and men during the entire study
* There was 1 additional case that could not be categorized as economic/verbal/physical
See this image and copyright information in PMC

References

    1. Baeten JM, Heffron R, Kidoguchi L, et al. Integrated Delivery of Antiretroviral Treatment and Pre-exposure Prophylaxis to HIV-1–Serodiscordant Couples: A Prospective Implementation Study in Kenya and Uganda. In: Siegfried N, editor. PLOS Med. 8. Vol. 13. 2016. p. e1002099. - DOI - PMC - PubMed
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    1. AVAC. (AVAC), AIDS Vaccine Advocate Coalition. Ongoing and Planned PrEP Demonstration and Implementation Studies. 2016 Dec; http://www.avac.org/resource/ongoing-and-planned-prep-demonstration-and-.... Published 2016. Accessed April 18, 2017.
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