Background: Intimate partner violence (IPV) is associated with increased risk of HIV acquisition and reduced engagement in HIV care. There is limited understanding of the ways in which IPV exposure and other maladaptive relationship dynamics may influence adherence to antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) for individuals in committed, HIV serodifferent partnerships. Methods We used binomial generalized linear mixed effect regression models to evaluate the association between IPV exposure and ART/PrEP adherence among members of serodifferent couples in Uganda. Secondarily, we assessed the association between relationship powerlessness and ART/PrEP adherence. Results: We enrolled and followed both partners in 149 heterosexual serodifferent couples. The partner living with HIV was female in 64% of couples. IPV exposure was associated with low ART adherence (15% vs. 5% in quarters with no IPV, odds ratio [OR]: 4.78, 95% confidence interval [CI] 1.48 – 15.42) but not low PrEP adherence (33% vs. 36%, p=0.69). Among HIV-negative individuals, those reporting moderate relationship powerlessness were less likely to have poor PrEP adherence compared to those with low relationship powerlessness (20% vs. 30%, OR: 0.57, 95% CI 0.36 – 0.90). We observed no association between relationship powerlessness and ART adherence. Conclusions: We found that IPV exposure was associated with low adherence to ART and that relationship powerlessness was associated with good adherence to PrEP. These findings contribute to the evidence base outlining the influence of IPV and relationship power on ART/PrEP adherence for individuals in HIV serodifferent unions.

中文翻译：

---

乌干达 HIV 血清差异夫妇中的亲密伴侣暴力以及 PrEP 和 ART 的遵守情况

背景：亲密伴侣暴力 (IPV) 与艾滋病毒感染风险增加和艾滋病毒护理参与度降低相关。对于 IPV 暴露和其他适应不良的关系动态可能如何影响对艾滋病毒血清差异伴侣关系中的个人坚持抗逆转录病毒治疗 (ART) 和暴露前预防 (PrEP) 的方式，人们的了解有限。 方法我们使用二项式广义线性混合效应回归模型来评估乌干达血清不同夫妇成员中 IPV 暴露与 ART/PrEP 依从性之间的关联。其次，我们评估了关系无力与 ART/PrEP 依从性之间的关联。 结果：我们招募并追踪了 149 对血清不同异性伴侣的双方。64% 的夫妇中，感染艾滋病毒的伴侣是女性。IPV 暴露与低 ART 依从性相关（在没有 IPV 的季度中，这一比例为 15% 对 5%，比值比 [OR]：4.78，95% 置信区间 [CI] 1.48 – 15.42），但与 PrEP 依从性低相关（33% 对 5%）。 36%，p=0.69）。在 HIV 阴性个体中，与低度关系无力感的人相比，报告中度关系无力感的人 PrEP 依从性较差的可能性较小（20% vs. 30%，OR：0.57，95% CI 0.36 – 0.90）。我们观察到关系无力感与 ART 依从性之间没有关联。 结论：我们发现 IPV 暴露与 ART 依从性低相关，而关系无能为力与 PrEP 依从性良好相关。这些发现有助于建立证据基础，概述 IPV 和关系力量对 HIV 血清不同联盟中个体 ART/PrEP 依从性的影响。