Associations between recent intimate partner violence and sustained viral suppression among pregnant and postpartum women living with HIV in western Kenya: A secondary analysis of a prospective cohort (Opt4Mamas).

OBJECTIVE

Pregnant women, including those living with HIV, are at high risk for intimate partner violence (IPV), but the relationship between IPV and viral suppression is unclear. This analysis identifies associations between IPV, viral suppression, and their correlates among pregnant and postpartum women.

METHODS

We conducted a secondary analysis of the Opt4Mamas prospective cohort study among pregnant women living with HIV in western Kenya (February 2019 to December 2021). Participants were enrolled during pregnancy and followed through 6 months postpartum with quarterly data collection. The primary outcome was sustained viral suppression (SVS, <1000 copies/mL) at all intervals from enrollment through 6 months postpartum. We used modified Poisson regression to obtain adjusted relative risks (aRR) and 95% confidence intervals (CI) for predictors of recent IPV.

RESULTS

Among 689 participants with ≥2 viral load results available for analysis, 564 (82%) achieved SVS and 68 (10%) reported recent IPV. Recent IPV showed no association with SVS (aRR: 0.98, 95% CI: 0.87, 1.11). However, lack of male partner support (aRR: 2.61, 95% CI: 1.14, 6.01), depression (aRR: 1.85, 95% CI: 1.16, 2.96), and stigma (aRR: 2.62, 95% CI: 1.52, 4.51) were associated with increased IPV. Non-disclosure of HIV status was associated with lower IPV reporting (aRR: 0.34, 95% CI: 0.14, 0.93).

CONCLUSION

While IPV was not associated with SVS, we identified important psychosocial correlates. Lack of male partner support, depression, and stigma were associated with increased IPV, emphasizing the need for interventions that address relationship dynamics, mental health, and HIV-related stigma to mitigate IPV exposure.