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Examining Associations Between Mental Health, IPV Exposure, HIV Risk Behaviors, and PrEP Use in South African Women: An Analysis of Data from the Charisma Study

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Abstract

Intimate partner violence (IPV) has been associated with poorer mental health outcomes and increased human immunodeficiency virus (HIV) risk behaviors. We examine the relations between IPV, mental health symptomology (defined as psychological distress and alcohol misuse), and engagement in HIV risk behaviors among a sample of South African women who participated in a randomized controlled trial of CHARISMA, an intervention to increase women’s agency to use oral pre-exposure prophylaxis (PrEP) safely and consistently as well as mitigate relationship challenges. We also examined the impact of trial participation on women’s mental health, as well as the impact of psychological distress on the effectiveness of the CHARISMA intervention. Mental health symptomology and IPV exposure were prevalent and associated with some HIV risk and protective behaviors. Trial participation reduced psychological distress. There was no evidence for mental health symptomology impacting the effectiveness of the CHARISMA intervention.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability

All code for data cleaning and analysis associated with the current submission is available from the corresponding author on reasonable request.

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Funding

The CHARISMA study was funded by the United States Agency for International Development through a cooperative agreement (AID-OAA-A-14-00012). This work was made possible by the generous support of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the American people through the United States Agency for International Development (USAID). Manuscript preparation was also supported in part by a National Institute of Mental Health training grant (F31 MH124328) awarded to Mr. Triplett.

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Authors and Affiliations

  1. Women’s Global Health Imperative, RTI International, Berkeley, CA, USA

    Noah S. Triplett, Sarah T. Roberts, Miriam Hartmann, Danielle Wagner & Elizabeth T. Montgomery

  2. Department of Psychology, University of Washington, Seattle, WA, USA

    Noah S. Triplett

  3. Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa

    Krishnaveni R. Reddy, Florence Mathebula & Thesla Palanee-Phillips

  4. Behavioral, Epidemiological & Clinical Sciences Unit, FHI 360, Durham, NC, USA

    Elizabeth E. Tolley

  5. Department of Global Health, University of Washington, Seattle, WA, USA

    Jared M. Baeten

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  1. Noah S. Triplett
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Contributions

All authors have read and approved the final manuscript. ETM, STR, KRR, EET, MH, JMB and TPP designed the research study. TPP, KRR, FM had direct oversight of data collection procedures and study conduct. LDW and MH provided ongoing management and monitoring of the study. NST analyzed the data for this study. NST led the writing of the paper, with contributions from all co-authors.

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Correspondence to Noah S. Triplett.

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The study was approved by the Human Research Ethics Committee at the University of Witwatersrand and overseen by the IRB at RTI International.

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All study participants provided written informed consent to participate in the study through a consent process approved by local ethical review committees in all research settings.

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Triplett, N.S., Roberts, S.T., Hartmann, M. et al. Examining Associations Between Mental Health, IPV Exposure, HIV Risk Behaviors, and PrEP Use in South African Women: An Analysis of Data from the Charisma Study. AIDS Behav 27, 2030–2040 (2023). https://doi.org/10.1007/s10461-022-03936-7

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