Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil
Braz. j. infect. dis
;
27(4): 102779, 2023. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1513869
ABSTRACT
ABSTRACT Syndemic psychosocial and reproductive factors affecting women's retention in HIV care remain understudied. We analyzed correlates of non-retention in a cohort of women with HIV in Brazil from 2000-2015. Participants self-reported exposure to physical/sexual violence, illicit drug use, adolescent pregnancy, or induced abortion. Lifetime history of these psychosocial stressors were used to create a syndemic score based on the presence or absence of these conditions. All dichotomous variables were summed (range 0 to 4), with greater scores indicating more syndemic factors experienced. Logistic regression models identified predictors of non-retention, defined as < 2 HIV viral load or CD4 results within the first year of enrollment. Of 915 women, non-retention was observed for 18%. Prevalence of syndemic factors was adolescent pregnancy (53.2%), physical/sexual violence (38.3%), induced abortion (27.3%), and illicit drug use (17.2%); 41.2% experienced > 2 syndemic conditions. Syndemic scores of 2 and 3 were associated with non-retention, as well as low education, years with HIV and seroprevalent syphilis. Psychosocial and reproductive syndemics can limit women's retention in HIV care. Syphilis infection predicted non-retention and could be explored as a syndemic factor in future studies.
Full text:
Available
Index:
LILACS (Americas)
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2023
Type:
Article
/
Project document
Affiliation country:
Brazil
/
United States
Institution/Affiliation country:
Fundação Oswaldo Cruz/BR
/
The University of Texas Health Science Center at Houston (UTHealth)/US
/
University of California Los Angeles/US
/
University of California San Francisco/US
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