Intimate Partner Violence Experiences Among Men Living with HIV in Rural Appalachia

Nicole Bryan,John Bassler,Danielle M Davidov,Melanie Fisher,Taron Dick

doi:10.1007/s10461-019-02438-3

Nicole Bryan, John Bassler + Show 3 more

Open Access

https://doi.org/10.1007/s10461-019-02438-3

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Abstract

There has been limited study of the syndemic link between HIV and intimate partner violence (IPV) among rural populations in the United States. We utilized the Revised Conflict Tactics Scale-2 to examine the past year prevalence, type (psychological aggression, physical assault, and sexual assault), and the impact of IPV on HIV clinical outcomes among men living with HIV in rural Appalachia. Approximately 39% of participants experienced some type of IPV in the preceding year, with 67% of those individuals experiencing more than 1 type of IPV. Approximately 77% of participants endorsing IPV exposure experienced psychological aggression. Most participants exposed to psychological aggression (70%) and/or physical assault (57%) were both victims and perpetrators, and those experiencing sexual assault reported being exclusively victims (65%). There were no significant differences in clinical outcomes including viral load and CD4 count, which may be secondary to small sample size derived from a clinic population with a high rate of virologic suppression (94%). This study demonstrates the need to assess IPV exposure in men living with HIV and further highlights the intricacies of relationship violence in these individuals.

Highlights

Intimate partner violence (IPV) refers to a category of domestic violence that according to the Centers for Disease Control and Prevention “includes physical violence, sexual violence, stalking, and psychological aggression” by a spouse or significant other [1]
Consistent with previous studies [57,58,59,60], we considered IPV to be present within the past year if the participant had a score of 1 or higher on the physical assault, sexual coercion, or severe psychological aggression subscales
In order to further characterize the experiences of those participants who reported exposure to IPV within the past year, we examined the types of IPV experienced (Table 2)

Summary

Introduction

Intimate partner violence (IPV) refers to a category of domestic violence that according to the Centers for Disease Control and Prevention “includes physical violence, sexual violence, stalking, and psychological aggression” by a spouse or significant other [1]. An increasing body of literature demonstrates a strong association between IPV and short and long term physical and psychological adverse outcomes. Numerous studies have demonstrated an increased risk of newly acquiring HIV infection among victims of IPV [8]. PrEP, which consists of an oral daily dose of tenofovir–emtricitabine, has emerged as an effective biomedical tool to decrease the risk of acquiring HIV infection in high-risk individuals [15]. There is evidence that African women in serodiscordant heterosexual relationships who are exposed to IPV exhibit lower rates of adherence to PrEP as measured by pill counts, serum tenofovir levels, and selfreported therapy interruptions [21, 22]

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