Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Jaimie Meyer

Abstract

Background: As the COVID-19 pandemic continues to evolve, there is a concern about elevated intimate partner violence (IPV) risk. Women living with HIV (WLWH) faced disproportionately high rates of IPV compared to women without HIV. The intersections of the co-occurring pandemics of COVID-19 and IPV present unique challenges to WLWH in different ways. Currently, we have limited evidence on the impact of COVID-19 on the experience of IPV among WLWH. Methods: This is a cross-sectional analysis of COVID-19 impact using baseline data from an ongoing, prospective, micro-longitudinal cohort study on HIV care engagement among WLWH who have experienced lifetime IPV. We evaluated COVID-19 impact along key domains (health, day-to-day life, sexual behavior, substance use, HIV care, mental health, financial status, and having conflict with partners). We compared sociodemographic characteristics, psychiatric disorders, substance use characteristics, and COVID-19 impact domains by IPV exposure recency, using independent t-tests or Fisher’s exact tests, and Pearson's chi-squared tests. We then built multiple linear regression models to investigate the association between IPV exposure and each of the different COVID-19 impact domains.  Results: Enrolled participants (n=84) comprised a group of relatively older women (mean 53.6y; SD=9.9), who were living with HIV for many years (mean 23.3y, SD=10), and all of whom had experienced lifetime IPV. Among 49 women who were currently partnered, 79.6% (n=39) reported ongoing IPV. There were no statistically significant differences between those experiencing ongoing IPV and those who were not (or not partnered) in terms of demographic characteristics, substance use, mental health, or COVID-19 impact. In multivariate models, ongoing IPV exposure was not associated with any COVID-19 impact domain. Anxiety and depression, however, were associated with a range of COVID-19 impacts, including on health, mental health, HIV care, and having conflict with partners. Hispanic ethnicity was also associated with differences in COVID-19 impact on health. More severe cocaine and opioid use were also associated with significant COVID-19 impact on day-to-day life.   Conclusions: The public health emergency period affected WLWH in varied ways, but impacts were most profound for women experiencing concurrent psychiatric and substance use disorders. Findings have important implications for future interventions to improve women’s health and social outcomes.

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This is an Open Access Thesis.

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