The effect of intimate partner violence on women's risk of HIV acquisition and engagement in the HIV treatment and care cascade: an individual-participant data meta-analysis of nationally representative surveys in sub-Saharan Africa
Bibliographic record
Abstract
Background: Achieving the 95-95-95 targets for HIV diagnosis, treatment, and viral load suppression (VLS) to end the HIV/AIDS epidemic hinges on eliminating structural inequalities, including intimate partner violence (IPV). Sub-Saharan Africa (SSA) has among the world's highest prevalence of IPV and HIV. We aim to examine the impact of IPV on recent HIV infection and women's engagement in the HIV care cascade. Methods: We pooled individual-level data from nationally representative surveys with information on physical and/or sexual IPV and HIV in SSA (2000-2020). We used Poisson regressions with robust standard errors to estimate adjusted prevalence ratios (aPR) of past year experience of IPV on recent HIV infection (measured using recency assays), past-year HIV testing, antiretroviral therapy (ART) uptake, and VLS among ever-partnered (currently/formerly married or cohabitating) women. Models were adjusted for women's age, age at sexual debut, residence type, marital status, education, and the survey's identifier (proxy of country and year). Findings: Fifty-seven surveys were available from thirty countries, encompassing 280,259 (N) individuals. One-fifth of women reported physical and/or sexual IPV in the past year. Six surveys had information on recent HIV infection and seven had data on ART uptake and VLS. Women experiencing past year IPV were 3.22 times (95%CI: 1.51-6.85, N=19,179) more likely to have a recent HIV infection, adjusting for potential confounders. Past year IPV was not associated with HIV testing (aPR=0.99, 95%CI: 0.98-1.01, N=274,506) or ART uptake (aPR=0.96, 95%CI:0.90-1.03, N=5,629). Women living with HIV (WLHIV) experiencing IPV in the past year were 9% less likely to achieve VLS (aPR=0.91, 95%CI: 0.85-0.98, N=5,627). Interpretation: Past year IPV was associated with recent HIV acquisition and lower VLS among WLHIV. Preventing IPV is inherently imperative but eliminating IPV could also be crucial to ending HIV/AIDS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.041 | 0.064 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.012 | 0.055 |
| Bibliometrics | 0.004 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".