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Intimate partner violence (IPV) is associated with poor HIV care linkage and retention, medication adherence, and viral suppression. However, limited knowledge exists regarding potential mechanisms linking IPV to these outcomes. We aimed to (a) identify the top barriers to accessing HIV care experienced by women living with HIV (WLHIV) who report a history of IPV and have suppressed viral load (VL) versus unsuppressed VL and (b) understand how these barriers influence VL, comparing WLHIV with a history of IPV to WLHIV without a history of IPV. Study data come from newly diagnosed WLHIV in rural Uganda participating in the standard-of-care control arm of a randomized trial (n = 152). Descriptive results ranking mean scores from highest to lowest showed that, among women with a history of IPV, irrespective of viral suppression status, paying for transportation to come to clinic, having to wait at the clinic for long periods of time, and finding a clinic within reasonable travel distance were the top three barriers to accessing HIV care. WLHIV with a history of IPV were significantly more likely to have unsuppressed VL versus suppressed VL if they reported higher levels of difficulty finding a clinic within reasonable travel distance (RRR = 1.7, 95% CI [1.1-2.7]), getting permission to take time off from work (RRR = 1.5, 95% CI [1.0-2.9]), and finding time to come to the clinic for an appointment (RRR = 1.6, 95% CI [1.0-2.6]). The same relationships were not present among WLHIV without a history of IPV, suggesting these barriers and their effect on VL may be uniquely related to IPV. Interventions should address IPV and HIV care continuum outcomes in tandem, targeting barriers to accessing HIV care likely associated with IPV. Additional research is necessary to better understand how IPV relates to HIV care barriers and VL.

Intimate partner violence (IPV) is associated with poor HIV care linkage and retention, medication adherence, and viral suppression. However, limited knowledge exists regarding potential mechanisms linking IPV to these outcomes. We aimed to (a) identify the top barriers to accessing HIV care experienced by women living with HIV (WLHIV) who report a history of IPV and have suppressed viral load (VL) versus unsuppressed VL and (b) understand how these barriers influence VL, comparing WLHIV with a history of IPV to WLHIV without a history of IPV. Study data come from newly diagnosed WLHIV in rural Uganda participating in the standard-of-care control arm of a randomized trial (n = 152). Descriptive results ranking mean scores from highest to lowest showed that, among women with a history of IPV, irrespective of viral suppression status, paying for transportation to come to clinic, having to wait at the clinic for long periods of time, and finding a clinic within reasonable travel distance were the top three barriers to accessing HIV care. WLHIV with a history of IPV were significantly more likely to have unsuppressed VL versus suppressed VL if they reported higher levels of difficulty finding a clinic within reasonable travel distance (RRR = 1.7, 95% CI [1.1-2.7]), getting permission to take time off from work (RRR = 1.5, 95% CI [1.0-2.9]), and finding time to come to the clinic for an appointment (RRR = 1.6, 95% CI [1.0-2.6]). The same relationships were not present among WLHIV without a history of IPV, suggesting these barriers and their effect on VL may be uniquely related to IPV. Interventions should address IPV and HIV care continuum outcomes in tandem, targeting barriers to accessing HIV care likely associated with IPV. Additional research is necessary to better understand how IPV relates to HIV care barriers and VL.

Objective: Savings-group interventions—a form of microfinance involving a small group of individuals who meet regularly to save—have been found to decrease intimate partner violence (IPV) risk among women in countries outside of the United States, but such groups have yet to be used or tested for this purpose in the United States. This study explores whether young women IPV survivors formerly in foster care would be interested in participating in a savings group and whether IPV experiences influence this interest. Method: Survey data were collected from foster care alumnae ages 18–24 years who reported ever experiencing physical, sexual, and/or emotional IPV (n = 62). I analyzed close- and open-ended data using descriptive and regression analyses and content analysis, respectively. Results: Over half (54%) the sample reported interest in savings-group participation. There was no statistically significant association between IPV characteristics (frequency, recency, fear) and savings-group interest, but interest was significantly associated with not having full-time employment and being in a current relationship. Participants were primarily interested for social-support reasons. Uninterested or apprehensive participants reported concerns about money and participating with others. Conclusions: Savings groups may be acceptable for IPV survivors with foster care history if the groups are trauma informed and tailored to address economic and social-support needs. [ABSTRACT FROM AUTHOR]

Objective: Disparate research findings suggest a need for more attention to intimate partner violence (IPV) survivors' experiences when reporting to police. To help address inequities and advance our understanding of racial/ethnic minoritized survivors' experiences with the U.S. legal system, we use critical race theory to investigate the association between survivors' race/ethnicity and police engagement and the degree of between- and within-group variability of survivors' perceived helpfulness of the legal system. Method: Survey data were collected from survivors accessing social services in Arizona. Data from two independent studies were collected (2012–2014, 2016–2018), and samples (Study 1: N = 660 ; Study 2: N = 377) were analyzed comparatively. We used regression models to examine each full sample and race-stratified samples. Results: We found different patterns of legal-system engagement across racial/ethnic groups, though severe IPV victimization was consistently associated with engagement. Some survivors of color reported higher perceived helpfulness of the legal system than white survivors. Indicators of perceived helpfulness included criminal conviction of the offender. Conclusions: This study is one of the first to examine between- and within-racial/ethnic-group differences in perceived helpfulness of the legal system among IPV survivors. Additional research is needed to understand how best to serve IPV survivors during a time of legal-system reform. [ABSTRACT FROM AUTHOR]