Examining Partner Characteristics and ARV Adherence Among South African Women Who Have Experienced Sexual Trauma

Abstract

Background: Prior studies have produced conflicting results regarding the associations between partner-level characteristics and antiretroviral treatment (ART) adherence, with some findings suggesting that romantic or sexual partners negatively impact ART adherence in women. This study aimed to examine ART adherence in association with individual- and partner-level factors among South African women with sexual trauma histories, a particularly vulnerable group with low levels of ART adherence. Methods: Data were collected as part of a larger trial of HIV-infected women with trauma histories in Cape Town. A structured survey assessed partner characteristics, including the frequency of partner drinking and serostatus-disclosure, as well as individual-level factors. The level of ART nonadherence was measured in the parent trial through medical record abstraction. Univariate and multivariate linear regression analyses were used to explore possible individual- and partner-level predictors of ART nonadherence. Log likelihood ratio tests were used to examine the possible moderation of disclosure on the association between hazardous drinking and ART nonadherence. Results: The combination of hazardous drinking and partner drinking accounted for a significant percentage of the variance in ART nonadherence (F(2, 41) = 3.632, p < .05). HIV-serostatus disclosure was found to significantly modify the relationship between hazardous drinking and nonadherence (LR chi2(1) = 5.67, p < .05). Conclusions: This study found that the frequency of partner drinking and hazardous drinking were significantly associated with ART nonadherence in HIV-seropositive South African women. These analyses additionally found that HIV-serostatus disclosure to a partner exacerbated the effects of hazardous drinking on nonadherence. These findings point to the importance of addressing problem drinking in women and men, and of considering the impact of partners on ART adherence.