Partner Violence and Substance-Related Service Use: Differences by HIV Status among Women.

Abstract

Introduction: Substance use disorders (SUDs) are prevalent among women living with HIV and women experiencing intimate partner violence (IPV). The study aimed to examine the association between IPV and substance-related service utilization among women living with and without HIV.

Methods: Utilizing Women's Interagency HIV Study (2013-2019) data, linear regression models in 2023-2024 estimated the association between recent and lifetime IPV and drug- and alcohol-related service utilization among women reporting substance use. Adjusted models included an interaction between IPV and HIV status, time-variant covariates, person-level fixed effects, and standard errors clustered at the individual level.

Results: Among 1,550 participants, 40% had a baseline history of IPV and 67% were living with HIV. Any recent IPV and recent psychological IPV were associated with increased alcohol-related service utilization (aβ=0.039, 95% CI=0.002-0.076; aβ=0.042, 95% CI=0.002-0.083; respectively). Recent sexual IPV was associated with increased drug- (aβ=0.082, 95% CI=0.000-0.165) and alcohol-related (aβ=0.131, 95% CI=0.028-0.233) service utilization. Those living with HIV who had experienced recent sexual IPV were less likely to utilize drug- (aβ=-0.143, 95% CI=-0.249- -0.037) and alcohol-related services (aβ=-0.122, 95% CI=-0.237- -0.007). Any lifetime IPV and lifetime psychological IPV were associated with decreased alcohol-related service use (aβ=-0.097, 95% CI=-0.169- -0.025; aβ=-0.096, 95% CI=-0.171- -0.020; respectively).

Conclusions: Findings highlight the complex relationship between IPV and SUD service utilization and differences of living with HIV on substance-related service utilization among women. Implementing a trauma-informed approach to address IPV, HIV, and substance use in healthcare settings could improve SUD-related service utilization and outcomes, and overall wellbeing among women.