Higher Sexual Relationship Power Associated With Optimal HIV Treatment and Care Outcomes Among Women Living With HIV in Heterosexual Relationships in Metro Vancouver

In this study among a longitudinal cohort of women living with human immunodeficiency virus (HIV) in Metro Vancouver, Canada (2014-2019), we used bivariate and multivariable logistic regression with generalized estimating equations to investigate associations between low, medium, and high relationship power and two outcomes among women in heterosexual relationships: (1) being on antiretroviral therapy (ART); (2) optimal ART use. Multivariable analysis suggested that high and medium relationship power were significantly associated with being on ART and optimal ART use. These findings suggest the critical importance of relationship power screening, strength-focused couples-based interventions and structural approaches to address gendered inequities, norms and HIV stigma.