Correlates of risk intimate partner violence in continued HIV care and treatment in Masvingo Province, Zimbabwe (2018–2023

Abstract

Intimate partner violence has been shown to be a detrimental factor to victims’ health status. It has been closely linked to acquisition of an HIV positive status. A retrospective cohort study on people who were screened for intimate partner violence at the point of HIV diagnosis was carried out following up their engagements with continued HIV care. The study sought to compare if there is any difference in patient attrition from care and treatment between HIV positive clients at risk of intimate partner violence and clients who are not at did not report risk. IPV exposed clients where matched one to one with none IPV exposed clients, matching was done at the facility level where data is abstracted. Women reporting IPV took longer to be initiated on ART (mean: 12 days, SD:33 days, range: 0 – 212 days) although the national guideline is same day ART initiation. Seventy-three percent of clients exposed to IPV had advanced HIV disease based compared to 17% none exposed (p<0.01). The study findings revealed that clients 15.6% of clients who experienced IPV missed their first clinical appointment compared to 7.8% of none exposed. Among the clients who attended their first clinical appointment, 18% reported poor adherence compared to 8% in none exposed clients. Poor engagement with care was reported in during the first 5 visits for IPV exposed clients however beyond this time similar engagements observed beyond the first year for retention. Clients exposed to IPV had 89% lower odds of being active on treatment at the end of the first year on ART (OR 0.1, 95% CI 0.0 – 0.5). Women exposed to IPV were also less likely to present their child for early infant diagnosis compared to women who were not exposed to IPV(p<0.01). The study could not conclude a statistically significant difference in viral suppression levels among the two groups. Participation in differentiated service delivery groups was comparable between the two groups. The study recommends formulation of differentiate service delivery model to improve retention in care of clients facing IPV. The detrimental effects of IPV in Masvingo province were observed to be a possible deterrent to reach HIV epidemic control.