Substance use serves as a mechanism through which gender-based violence (GBV) impacts HIV outcomes among women in the United States, according to findings published in AIDS. Amy Conroy, PhD, MPH, and colleagues examined longitudinal data from 1,717 women with HIV to determine whether substance abuse mediates relationships between GBV and poor ART adherence, and GBV and suboptimal engagement in care. The researchers found that 5% of women reported GBV, 17% reported poor ART adherence, and 15% reported at least one missed appointment in the previous 6 months. Women who experienced GBV had greater odds of poor adherence (adjusted OR [aOR], 1.99; 95% CI, 1.40-2.83) and missed appointments (aOR, 1.92; 95% CI, 1.32-2.33). Heavy drinking and illicit drug use mediated the association between GBV and suboptimal adherence and the association between GBV and missed appointments, respectively. “To optimize HIV treatment and care among women, interventions should address the combined epidemics of substance use, violence, and HIV,” Dr. Conroy and colleagues wrote.