Abstract
Introduction: 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. Methods: 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. Results: 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). Conclusions: 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.