RT Article
T1 Interpersonal violence and other social-structural barriers associated with needing HIV treatment support for women living with HIV
JF Journal of interpersonal violence
VO 37
IS 11/12
A1 Erickson, Margaret
A2 Shannon, Kate
A2 Ranville, Flo
A2 Magagula, Patience
A2 Braschel, Melissa
A2 Ratzlaff, Andrea
A2 Pick, Neora
A2 Kestler, Mary
A2 Deering on behalf of the SHAWNA Project, Kathleen
LA English
YR 2022
UL https://krimdok.uni-tuebingen.de/Record/1883345472
AB 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.
K1 ART adherence
K1 HIV
K1 PTSD
K1 alcohol and drugs
K1 cultural contexts
K1 Domestic Violence
K1 Trauma
K1 trauma-informed care
K1 Women
DO 10.1177/0886260520983257