Systematic screening of gender violence and domestic violence among HIV-positive patients: the VIHOLETA study

ABSTRACT

We conducted a multicentre observational study in people living with HIV (PLHIV) on antiretroviral therapy in Alicante (Spain) from 2019 to 2020 aiming to analyse the prevalence of abuse and assess treatment adherence according to this variable. We used the Abuse Assessment Screen tool, the simplified medication adherence questionnaire and the medication possession ratio to assess outcomes.. Of the 161 included PLHIV, 53 (32.9%) had suffered abuse (27 emotional abuse, 6 physical abuse, 3 sexual abuse, 13 emotional and physical abuse, 4 unknown type). Seven (4.3%) had suffered abuse in the last year (5 emotional, 2 physical). Abuse had lasted a median of 48 months (interquartile range 12–81). HIV status was considered as a cause of violence by 9.4% of victims. In the multivariable analysis, only abuse was independently associated with non-adherence [adjusted odds ratio (aOR) 3.92; 95% confidence interval (CI) 1.80–8.84; p = 0.0007]. Abuse (aOR 6.14; 95% CI 1.63–27.70; p = 0.001) and previous incarceration (aOR 15.08 95% CI 2.71–104.71; p = 0.003) were associated with detectable viral load. In conclusion, the prevalence of abuse is high in PLHIV, hampering adherence and virological success. Abuse screening tools should be incorporated into routine HIV care.

KEYWORDS:

• Violence
• gender violence
• intimate partner violence
• physical abuse
• HIV infection
• medication adherence

Acknowledgments

The authors are grateful to the Seimc Gesida Foundation, and especially to Marta de Miguel Montero, for their assistance with REDCap electronic data capture tools. The authors are in debt to all VIHOLETA study participants and all staff at the Infectious Diseases Clinics of our hospitals

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Conselleria de Cultura, Educación y Ciencia, Generalitat Valenciana [grant number GV/2018/168].