Content area
Full Text
Background
He flushed all of my meds down the toilet. He said he wanted me to die faster from AIDS (30 year-old Latina woman in jail in a long-standing abusive partnership).
Intimate partner violence (IPV) can be a major barrier to longitudinal HIV care, including persistence on antiretroviral therapy (ART) ([4] Bae et al. , 2011; [58] Schafer et al. , 2012). Poor retention in care along the HIV treatment cascade reduces the likelihood of ultimately achieving viral suppression and increases risk of ongoing HIV transmission ([14] Cohen et al. , 2011; [2] Andrews et al. , 2012; [26] Gardner et al. , 2011). Recent mathematical modeling ([31] Granich et al. , 2009), empirical community data ([17] Das et al. , 2010; [53] Montaner et al. , 2010), and randomized controlled trials ([14] Cohen et al. , 2011) confirm the importance of sustained engagement in care as central to the HIV "treatment as prevention" paradigm ([52] Montaner, 2011). The US National HIV/AIDS Strategy Plan was recently revised to include: "(People living) [...] with HIV can be at risk for IPV, which can impede adherence and stability in care" ([27] Gay et al. , 2010; [54] The White House Office of National AIDS Policy, 2010, p. 28) to highlight the importance of addressing IPV in secondary HIV prevention efforts. On an international level, a recent UNAIDS Global Report made a similar call: "Given that violence is widespread and that there is a clear association between violence against women and the spread of HIV, national HIV responses must include specific interventions to address violence" ([74] UNAIDS, 2010). Efforts to address violence are complicated by the intertwined nature of HIV, IPV, and substance use disorders (SUDs) forming the cornerstones of the "SAVA (Substance Abuse, Violence, and HIV/AIDS) Syndemic" ([61] Singer, 1994; [50], [51] Meyer et al. , 2011a, b; [37] Johnson et al. , 2003). These overlapping epidemics synergize, resulting in exaggerated negative health consequences.
IPV victimization has been associated with increased sex and drug risk-taking behaviors ([15] Collins et al. , 2005; [68] Stockman et al. , 2010; [75] Walters and Simoni, 1999; [79] Wingood and DiClemente, 1997; [13] Cohen et al. , 2000; [24] El-Bassel et al. , 2005). International research and policy has primarily...