Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil

Braz J Infect Dis. 2023 May 22;27(4):102779. doi: 10.1016/j.bjid.2023.102779. Online ahead of print.ABSTRACTSyndemic 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.PMID:37230150 | PMC:PMC10245108 | DOI:10.1016/j.bjid.2023.102779

Source: Braz J Infect Dis - May 25, 2023 Category: Infectious Diseases Authors: Christine M Zachek Lara E Coelho Jesse L Clark Rosa M S M Domingues Paula M Luz Ruth K Friedman Ângela C Vasconcelos de Andrade Valdilea G Veloso Jordan E Lake Beatriz Grinsztejn Raquel B De Boni Source Type: research