Submission ID 131887
| Issue/Objective | While HIV and TB program increasingly emphasize integrated care, less attention is given to upstream social determinants such as gender based violence (GBV). GBV may shape adherence, care engagement, and outcomes for people living with HIV (PLHIV) and individuals affected by TB, particularly in high burden settings. Objective: This study assessed the association between GBV exposure and HIV treatment adherence, viral suppression, and access barriers among PLHIV in Gombe State, and examined how GBV exposure compounds treatment barriers among individuals with TB and TB/HIV coinfection. |
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| Methodology/Approach | We conducted a four-month cross sectional study (December 2025-March 2026) among 279 adults enrolled through the Global Fund N THRIP project across rural and urban Gombe State. Participants included PLHIV, individuals with a history of TB, and those with TB/HIV co infection. Data captured GBV exposure, HIV/TB status, ART use, adherence patterns, viral load status, and barriers to care. Associations between GBV and treatment outcomes were examined using Stata; data were collected electronically using REDCap. |
| Results | GBV exposure was significantly associated with lower viral suppression (57.6% vs. 92.7%, p<0.001). GBV prevalence was high (74.2%), with emotional and community level violence most frequently reported. Participants comprised PLHIV (73.5%), TB only participants (18.6%), and those with TB/HIV co infection (7.9%). Although ART uptake was 100% among those in care, adherence gaps were evident. Among GBV exposed participants, 31.1% reported missing at least one dose in the past month compared with 18.2% among those without GBV. GBV exposed participants also reported higher barriers, including stigma (44.0%), side effects (50.2%), and distance to care (16.4%). Majority reported that violence affected adherence (65.0%) and prevented access to HIV care when needed (58.5%). Barriers may be compounded for individuals affected by TB and TB/HIV co infection due to additional treatment burden. |
| Discussion/Conclusion | GBV operates as a structural driver of poorer HIV outcomes by undermining adherence and access to care and may further complicate TB and TB/HIV co infection management. Integrating GBV responsive screening, referral pathways, and differentiated support within HIV and TB services is essential to achieving equitable care continuity. |
| Presenters and Affiliations | Joseph Ozigbo Institute of Human Virology, Nigeria Charity Sanni Institute of Human Virology, Nigeria stella Ijioma Institute of Human Virology, Nigeria Hasiya Bello Institute of Human Virology, Nigeria Miriam Bathnna Institute of Human Virology, Nigeria Kazeem Ayodeji Institute of Human Virology, Nigeria Adetola Adegoke Institute of Human Virology, Nigeria Opeyemi Adebayo Institute of Human Virology, Nigeria Olayemi Olupitan Institute of Human Virology, Nigeria Evaezi Okpokoro International Research Centre for Excellence; Institute of Human Virology, Nigeria Aderonke Agbaje Office of the Chief Executive Officer, Institute of Human Virology, Nigeria Charles Mensah Office of the Chief Executive Officer Institute of Human Virology, Nigeria Temitope Ilori National Agency for the Control of AIDS (NACA) Charity Oga-Omenka Assistant Professor at the School of Public Health Sciences, University of Waterloo. Janet Kimeu The Global Fund |
