The three main study outcomes were different forms of IPV perpetrated by MLHIV (psychological and physical IPV (PPV), severe physical IPV (SPV), and sexual IPV (SV)). All three were created using the methods described in the subsection “Statistical analysis” (see below) and each was defined as a three-class categorical variable reflecting the level of violence perpetrated (e.g., no PPV; moderate level of PPV; high level of PPV).

The secondary study outcomes were the two following binary variables: ‘unstable aviremia’ and ‘HIV transmission risk’. Participants were classified with unstable aviremia if i) they were not currently on ART or were on ART for less than 6 months; ii) if they were on ART for at least 6 months but had a detectable viral load and/or were poorly adherent to ART (defined as taking <80% of their prescribed ART doses and/or reporting treatment interruptions for at least two consecutive days in the 4 weeks prior to the survey [27]). Given that viral suppression prevents HIV transmission to HIV-negative partners in heterosexual couples [33], HIV transmission risk was defined as a combination of unstable aviremia and inconsistent condom use with their most recent or, for those who reported more than one partner in the previous 12 months, with at least one of their two most recent female partners of negative or unknown HIV status. Inconsistent condom use was defined as replying “Never, sometimes or almost always” to the survey question “In the last 12 months, have you used condoms with this partner?”, and/or replying “No” to the question “During your most recent sexual intercourse with this partner, did you use a condom?”.

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