AI Article Synopsis
- Gender-based violence (GBV) negatively impacts women's engagement in HIV care, leading to poorer adherence to treatment and missed appointments.
- The study found that mental health issues, specifically depression, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD), mediate the relationship between GBV and poor adherence, with significant percentages attributed to each mental health condition.
- Interventions aimed at improving HIV care engagement should prioritize addressing mental health needs of women affected by GBV, regardless of their food insecurity status.
Article Abstract
Background: Gender-based violence (GBV) is associated with poorer engagement in HIV care and treatment. However, there is a dearth of research on the psychological (eg, mental health) and structural (eg, food insecurity) factors that mediate and moderate this association. GBV could lead to poor mental health, which in turn affects adherence, whereas food insecurity could worsen the effect of GBV on engagement in care. This study uses data from the Women's Interagency HIV Study to address these gaps.
Methods: Women completed 6 assessments from 2013 to 2016 on GBV, mental health, food insecurity, adherence to antiretroviral therapy, and missed HIV care appointments in the past 6 months. Multilevel logistic regression models estimated associations between GBV and engagement in care and whether associations were mediated by depression, generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) and moderated by food insecurity.
Results: GBV was associated with higher odds of suboptimal adherence (adjusted odds ratio: 1.88; 95% confidence interval: 1.24 to 2.87) and missed appointments (adjusted odds ratio: 1.76; 95% confidence interval: 1.16 to 2.67). The association between GBV and adherence was mediated by depressive symptoms, GAD, and PTSD, accounting for 29.7%, 15.0%, and 16.5%, respectively, of the total association. The association between GBV and missed appointments was mediated by depression and GAD, but not PTSD, with corresponding figures of 25.2% and 19.7%. Associations did not differ by food insecurity.
Conclusions: GBV is associated with suboptimal engagement in care, which may be explained by mental health. Interventions should address women's mental health needs, regardless of food insecurity, when improving engagement in HIV care.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752473 | PMC |
| http://dx.doi.org/10.1097/QAI.0000000000002848 | DOI Listing |
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