Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia.
BACKGROUND
Prevention of mother-to-child transmission (PMTCT) depends critically on HIV-positive women's adherence to antiretroviral drugs during and after pregnancy. Adherence among pregnant and breastfeeding women remains a challenge across sub-Saharan Africa. Power dynamics within couples, such as intimate partner violence, has largely been neglected in research regarding PMTCT adherence.


OBJECTIVE
This study aims to determine if there is a relationship between intimate partner violence and non-adherence to PMTCT.


METHODS
In 2014, using a verbally administered cross-sectional survey at a large public health clinic in Lusaka, Zambia, 320 HIV-positive postpartum women, who were currently married or living with a man, provided information on their drug adherence during and after pregnancy, as well as relationship dynamics. Adherence was defined as the woman reporting she took or gave to the infant at least 80% of prescribed medication doses.


RESULTS
Experiencing intimate partner violence was associated with decreased odds of adherence to PMTCT during and after pregnancy. Different forms of violence affected PMTCT adherence differentially. Physical violence had a less pronounced effect on non-adherence than emotional and sexual violence. A dose-response relationship between intimate partner violence and non-adherence was also observed.


CONCLUSIONS
Intimate partner violence is associated with non-adherence to PMTCT during and after pregnancy, which deserves increased attention in the effort to eliminate mother-to-child transmission of HIV.
['Hampanda|Karen M|KM|']
D000328:Adult D044966:Anti-Retroviral Agents D003430:Cross-Sectional Studies D005260:Female D015658:HIV Infections D006801:Humans D007223:Infant D018445:Infectious Disease Transmission, Vertical D008297:Male D055118:Medication Adherence D011247:Pregnancy D013179:Spouse Abuse D015024:Zambia
Intimate partner violence Prevention of mother-to-child transmission Zambia Sub-Saharan Africa HIV Antiretroviral adherence