Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Jaimie P. Meyer

Abstract

Background: WLWH face persistent gaps in HIV care engagement, and IPV is a critical determinant of health in this population. Few studies have examined barriers and facilitators to care by current IPV exposure and relationship status using mixed methods.Methods: We analyzed cross-sectional baseline data from 158 WLWH (M age=54.9 years [SD=10.41]) with lifetime IPV exposure enrolled in the I-CARE study in Connecticut. Participants were grouped by: (1) IPV with a current partner (n=74, 46.8%), (2) currently partnered without IPV (n=19, 12.0%), and (3) not currently partnered (n=65, 41.1%). Barriers and facilitators to HIV care engagement were assessed quantitatively and qualitatively using a convergent mixed-methods approach, with findings integrated through a joint display matrix organized by social-ecological domain. Group differences were evaluated using ANOVA and chi-square or Fisher's exact tests. Results: Participants had been living with diagnosed HIV for 24.4 years on average (SD=10.22). Hazardous alcohol use was higher among women experiencing current IPV (24.3%; p=.048). Individual-level barriers were the most endorsed across all groups with no significant between-group differences. Partner support differed significantly (p<.0001), with 91.9% of women experiencing IPV reporting partner support versus 35.4% of non-partnered women. Conclusions: Individual-level barriers shape HIV care engagement among WLWH regardless of IPV status. The coexistence of partner violence and partner support within the same relationship has direct implications for safety planning and HIV care delivery in this population.

Comments

This is an Open Access Thesis.

Download
Open Access

This Article is Open Access

Share

COinS