The proposed mixed-methods study aims to examine the complex relationship between intimate partner violence (IPV) and reproductive coercion, mental health and HIV treatment adherence and disease progression. Pathways including substance abuse, depression and post-traumatic stress disorder will be examined. Women will be recruited from an urban HIV clinic that serves a primarily low income, African American population. African American women are disproportionally affected by the intertwined epidemics of HIV, violence and substance abuse. Phase 1 of the study will include quantitative data regarding past year, IPV, reproductive coercion, PTSD symptoms, depressive symptoms, substance abuse, and HIV medication adherence collected from eligible women. Participant's medical records will be reviewed to obtain biologic markers of disease progression and medication adherence (CD4 count and viral load) as well as covariates related to HIV disease progression (hospitalizations, opportunistic infections) and verification of mental health related diagnoses (PTSD, depression, substance abuse). Prevalence of IPV and reproductive coercion will be estimated, prior to examining the direct and mediated effects of IPV and reproductive coercion on HIV disease progression and treatment adherence (CD4 counts, viral load and missed clinic visits). Following analysis of Phase 1 data, a subsample of women will be purposefully selected for Phase 2 qualitative interviews.
The aim of these qualitative interviews is to explore women's perceptions on IPV and reproductive coercion and the role in adherence and disease progression. The findings from the proposed study will be used to inform culturally competent interventions to reduce health disparities among urban, HIV positive women.

Public Health Relevance

The overall career goal of the applicant is to contribute to the evidence needed to reduce disparities in health outcomes for urban women, with a specific focus on African American women who are HIV positive. This study proposes to build on existing evidence on HIV care and treatment adherence among urban, HIV positive women.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31MH100995-02
Application #
8735666
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Stoff, David M
Project Start
2013-09-01
Project End
2016-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Patch, Michelle; Anderson, Jocelyn C; Campbell, Jacquelyn C (2018) Injuries of Women Surviving Intimate Partner Strangulation and Subsequent Emergency Health Care Seeking: An Integrative Evidence Review. J Emerg Nurs 44:384-393
Anderson, Jocelyn C; Campbell, Jacquelyn C; Glass, Nancy E et al. (2018) Impact of intimate partner violence on clinic attendance, viral suppression and CD4 cell count of women living with HIV in an urban clinic setting. AIDS Care 30:399-408
Grace, Karen Trister; Anderson, Jocelyn C (2018) Reproductive Coercion: A Systematic Review. Trauma Violence Abuse 19:371-390
Campbell, Jacquelyn C; Anderson, Jocelyn C; McFadgion, Akosoa et al. (2018) The Effects of Intimate Partner Violence and Probable Traumatic Brain Injury on Central Nervous System Symptoms. J Womens Health (Larchmt) 27:761-767
Anderson, Jocelyn C; Glass, Nancy E; Campbell, Jacquelyn C (2017) Conducting Clinically Based Intimate Partner Violence Research: Safety Protocol Recommendations. Nurs Res 66:405-409
Anderson, Jocelyn C; Grace, Karen Trister; Miller, Elizabeth (2017) Reproductive coercion among women living with HIV: an unexplored risk factor for negative sexual and mental health outcomes. AIDS 31:2261-2265
Pollitt, Erin N; Anderson, Jocelyn C; Scafide, Katherine N et al. (2016) Alternate Light Source Findings of Common Topical Products. J Forensic Nurs 12:97-103
Anderson, Jocelyn C; Stockman, Jamila K; Sabri, Bushra et al. (2015) Injury outcomes in African American and African Caribbean women: the role of intimate partner violence. J Emerg Nurs 41:36-42