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

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

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

Among 1,550 participants, 40% had a baseline history of intimate partner violence and 67% were living with HIV. Any recent intimate partner violence and recent psychological intimate partner violence 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 intimate partner violence 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 intimate partner violence 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 intimate partner violence and lifetime psychological intimate partner violence 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).

Findings highlight the complex relationship between intimate partner violence and substance use disorder service utilization and differences of living with HIV on substance-related service utilization among women. Implementing a trauma-informed approach to address intimate partner violence, HIV, and substance use in healthcare settings could improve substance use disorder-related service utilization and outcomes, and overall well-being among women.