A Prospective Study of Intimate Partner Violence as a Risk Factor for Detectable Plasma Viral Load in HIV-Positive Women Engaged in Transactional Sex in Mombasa, Kenya

We conducted a prospective cohort study to evaluate intimate partner violence (IPV) as a risk factor for detectable plasma viral load in HIV-positive female sex workers (FSWs) on antiretroviral therapy (ART) in Kenya. 

IPV in the past year was defined as ≥1 act of physical, sexual, or emotional violence by the index partner (i.e. boyfriend/husband). The primary outcome was detectable viral load (≥180 copies/ml). In-depth interviews and focus groups were included to contextualize results. Analyses included 195 women (570 visits). 

Unexpectedly, IPV was associated with significantly lower risk of detectable viral load (adjusted relative risk 0.21, 95 % CI 0.05-0.84, p-value = 0.02). Qualitative findings revealed that women valued emotional and financial support from index partners, despite IPV. IPV was not a major barrier to ART adherence. 

The observed association between IPV and lower risk of detectable viral load in FSWs may be due to unmeasured personal and relationship factors, warranting further research.

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By:  Wilson KS1,2, Wanje G3, Yuhas K4, Simoni JM5, Masese L6, Vander Stoep A7, Jaoko W3, Hughes JP8, Richardson BA4,8, Scott McClelland R4,7,6,3.

• 1Department of Global Health, University of Washington, Seattle, 98104, USA. ksw@uw.edu.
• 2Department of Epidemiology, University of Washington, Seattle, USA. ksw@uw.edu.
• 3Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.
• 4Department of Global Health, University of Washington, Seattle, 98104, USA.
• 5Department of Psychology, University of Washington, Seattle, USA.
• 6Department of Medicine, University of Washington, Seattle, USA.
• 7Department of Epidemiology, University of Washington, Seattle, USA.
• 8Department of Biostatistics, University of Washington, Seattle, USA. 
• AIDS Behav. 2016 May 3. 

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