Postdoctoral researcher addresses intimate partner violence and HIV treatment in Uganda 

Intimate partner violence is hindering HIV treatment efforts for adolescent girls and young women in Uganda, according to a recent correspondence in The Lancet, co-authored by Josephine Nabayinda, a postdoctoral research associate at the Brown School’s International Center for Child Health and Development (ICHAD). 

The correspondence highlights a connection between abuse and reduced adherence to antiretroviral therapy (ART), an essential treatment for people living with HIV. Co-authors include Samuel Kizito, research assistant professor, and Fred Ssewamala, the William E. Gordon Distinguished Professor—both of WashU’s Brown School—as well as Mary McKay, executive vice provost. 

Uganda continues to face some of the highest HIV rates among young people, especially adolescent girls and young women, who are disproportionately affected. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), an estimated 3.4 million people aged 15 to 24 worldwide are living with HIV, with nearly two-thirds of them in sub-Saharan Africa. 

“For adolescent girls and young women living with HIV, adherence to antiretroviral therapy (ART) is crucial not only for their health, but also for reducing HIV transmission to sexual partners and infants during pregnancy and breastfeeding,” the authors wrote. “However, intimate partner violence poses a substantial barrier to effective HIV management.” 

Citing recent research, the correspondence notes that adolescent girls and young women who experience intimate partner violence are up to three times more likely to contract HIV. They’re also less likely to begin or consistently take ART, leading to poorer health outcomes and increased risk of death.  

The authors also emphasized the role of financial dependence in perpetuating cycles of abuse. Many young women remain trapped in harmful relationships due to economic reliance on their abusers, further compromising their ability to access and adhere to treatment. 

“For some, an HIV-positive status can trigger violence from intimate partners, family members, or even health-care providers,” they said. “This violence diminishes their agency and autonomy, making it difficult to negotiate safe sex practices or access health-care services.” 

The authors call for more integrated interventions that address both economic empowerment and personal safety. While current HIV strategies often focus on social and behavioral factors, the researchers argue that more comprehensive approaches are needed. 

“Economic empowerment is an essential, yet underused strategy in the HIV response,” they wrote. “By enhancing adolescent girls’ and young women’s economic autonomy, we can improve their ability to adhere to ART, reduce their reliance on abusive partners, and ultimately break the cycle of violence and poor health outcomes.”