Trauma-Informed Practices to Address Intersections Between HIV and Intimate Partner Violence Among Women: Perspective of Community Service Providers

Désilets, Laura; Fernet, Mylène; Otis, Joanne; Cousineau, Marie‐Marthe; Massie, Lyne; Pokomandy, Alexandra de; Mensah, Maria Nengeh

doi:10.1097/jnc.0000000000000163

Cited by 7 publications

(10 citation statements)

References 34 publications

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“…This nding was consistent with previous research examining reasons for clinical trial participation among women, such as the opportunity for self-re ection or self-empowerment (Green, 2006;Grella and Joshi, 1999). Women in both studies believed their lives were out of control or needed services to help them regain control of their lives (Green et al, 2006;Grella and Joshi, 1999) This nding has been supported by the literature on the importance of trauma-informed care among women with HIV who experience intimate partner violence (Désilets et al, 2020). Many of the women discussed social reasons for study participation, such as being in uenced or pressured by members of their social network (e.g.…”

Section: Discussionsupporting

confidence: 84%

Recruitment, experience, and retention among women with HIV and hazardous drinking enrolled in the WHAT-IF? Study

Canidate

Cook

Varma

et al. 2020

Preprint

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Background: Despite efforts by the NIH to enhance the participation of women and minorities in clinical research, women with HIV continue to remain underrepresented in alcohol intervention research. The purpose of this study is to better understand the reasons why women with HIV and hazardous drinking participated in the WHAT-IF? Study and to discuss their experience (positive or negative) in the study.Methods: Convenience and theoretical sampling were used to recruit women with HIV and hazardous drinking to complete qualitative interviews. These women had previously completed a clinical alcohol intervention trial and had consented to be contacted in the future for study-related purposes. The biopsychosocial model was used to frame the interview questions that assessed multiple determinants of drinking behavior and helped explain linkages to broader health constructs.Results: A total of 20 women with HIV and hazardous drinking completed the qualitative interview. Several factors were identified by the women as influential in their decision to participate in the WHAT-IF? study, such as the ability to quit or reduce their drinking to nonhazardous levels (biological), the ability to gain knowledge or a greater understanding of the negative effects of hazardous drinking on HIV disease progression (psychological), and peer pressure and monetary compensation (social). Also, the women identified factors (positive or negative) associated with their clinical trial experience, such as the effects of the study medication on the woman's body (biological), thoughts and feelings toward study procedures (i.e. medication, lab work, study assessments) and the length of the study (psychological), and the interactions with the WHAT-IF? Study staff (social).Conclusion: Recruiting and retaining women with HIV in alcohol intervention research remains a challenge. Findings from this study suggest that women with HIV who are hazardous drinkers may benefit from participating in research studies that could help them to reduce or quit their drinking, increase their knowledge about specific behavior changes, and earn monetary compensation. Also, positive staff interactions may be instrumental in retaining minority women in alcohol intervention research.

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Section: Discussionsupporting

confidence: 84%

Recruitment, experience, and retention among women with HIV and hazardous drinking enrolled in the WHAT-IF? Study

Canidate

Cook

Varma

et al. 2020

Preprint

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“…Strategies are needed to provide trauma-informed care to ALHIV [15,[46][47][48][49][50]. Key targets for intervention may centre on preventing, addressing, or mitigating each of the contributing impacts of trauma, stigma, lacking social support and mental health disorders.…”

Section: Discussionmentioning

confidence: 99%

“I just keep quiet about it and act as if everything is alright” – The cascade from trauma to disengagement among adolescents living with HIV in western Kenya

Enane

Apondi

Omollo

et al. 2021

J. Intern. AIDS Soc.

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Introduction There are approximately 1.7 million adolescents living with HIV (ALHIV, ages 10 to 19) globally, including 110,000 in Kenya. While ALHIV experience poor retention in care, limited data exist on factors underlying disengagement. We investigated the burden of trauma among disengaged ALHIV in western Kenya, and its potential role in HIV care disengagement. Methods We performed in‐depth qualitative interviews with ALHIV who had disengaged from care at two sites, their caregivers and healthcare workers (HCW) at 10 sites, from 2018 to 2020. Disengagement was defined as not attending clinic ≥60 days past a missed scheduled visit. ALHIV and their caregivers were traced through phone calls and home visits. Interviews ascertained barriers and facilitators to adolescent retention in HIV care. Dedicated questions elicited narratives surrounding traumatic experiences, and the ways in which these did or did not impact retention in care. Through thematic analysis, a conceptual model emerged for a cascade from adolescent experience of trauma to disengagement from HIV care. Results Interviews were conducted with 42 disengaged ALHIV, 34 caregivers and 28 HCW. ALHIV experienced a high burden of trauma from a range of stressors, including experiences at HIV disclosure or diagnosis, the loss of parents, enacted stigma and physical or sexual violence. A confluence of factors – trauma, stigma and isolation, and lack of social support – led to hopelessness and depression. These factors compounded each other, and resulted in complex mental health burdens, poor antiretroviral adherence and care disengagement. HCW approaches aligned with the factors in this model, suggesting that these areas represent targets for intervention and provision of trauma‐informed care. Conclusions Trauma is a major factor underlying disengagement from HIV care among Kenyan adolescents. We describe a cascade of factors representing areas for intervention to support mental health and retention in HIV care. These include not only the provision of mental healthcare, but also preventing or addressing violence, trauma and stigma, and reinforcing social and familial support surrounding vulnerable adolescents. In this conceptualization, supporting retention in HIV care requires a trauma‐informed approach, both in the individualized care of ALHIV and in the development of strategies and policies to support adolescent health outcomes.

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“…In conducting screenings, providers should build rapport by emphasizing safety and establishing trust, with an understanding that this can be done without knowing details of past trauma. TVI principles may be integrated into healthcare practices through curriculum, training, and continuing education; further research to understand how these skills may be applied and what impact this has on clinical care outcomes remains a priority (Desilets et al, 2020). Research that further delineates the mechanisms by which violence is associated with structural factors remains critical to inform development and implementation of programs and supports (Conroy et al, 2022).…”

Section: Study Implications and Recommendationsmentioning

confidence: 99%

Prevalence and Social-Structural Correlates of Gender-Based Violence Against Women Living With HIV in Metro Vancouver, Canada

Ohtsuka

Shannon

Zucchet

et al. 2022

J Interpers Violence

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Violence experienced by cisgender (cis) and gender minority women living with HIV is known to be high. More work is needed to better understand how to support women living with HIV who have experienced violence. The objectives of this study are therefore to identify the prevalence and correlates of violence by any perpetrator among women living with HIV in a Canadian setting. Data were drawn from 9 years (January, 2010 to February, 2019) of a longitudinal community-based open cohort study of 350+ cis and trans women living with HIV who were living and/or accessed care in Metro Vancouver, Canada (Sexual Health and HIV/AIDS: Women’s Longitudinal Needs Assessment “SHAWNA”). Participants completed baseline and biannual follow-up interviews. Bivariate and multivariable logistic regression with generalized estimating equations (GEE) were performed to identify correlates of recent (last 6 months) violence (physical and/or sexual) by any perpetrator. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CIs) are presented. At baseline, prevalence of violence was high: 95.5% (recent = 19.4%) of participants reported lifetime physical and/or sexual violence, 94.8% (recent = 17.9%) reported lifetime physical violence, and 84.5% (recent = 5.7%) reported lifetime sexual violence. In multivariable logistic regression with GEE, the following variables were associated with higher odds of recent physical/sexual violence: youth (<30 years) (AOR: 1.60, 95% CI [1.15, 2.22]), recent unstable housing/homelessness (AOR: 1.96, 95% CI [1.30, 2.97]), recent food insecurity (AOR: 1.57, 95% CI [1.13, 2.17]), recent incarceration (AOR: 1.85, 95% CI [1.18, 2.91]), recent opioid use (AOR: 1.38, 95% CI [1.04, 1.82]), recent stimulant use (AOR: 2.48, 95% CI [1.72, 3.56]), and lifetime HIV status disclosure without consent (AOR: 1.59, 95% CI [1.13, 2.24]). Trauma- and violence-informed (TVI) policies that include a focus on confidentiality and safe disclosure practices should be integrated into existing housing, incarceration, and harm reduction programs, and HIV care and practice for women living with HIV. Programs and policies that address high levels of violence remain critical.

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Trauma-Informed Practices to Address Intersections Between HIV and Intimate Partner Violence Among Women: Perspective of Community Service Providers

Cited by 7 publications

References 34 publications

Recruitment, experience, and retention among women with HIV and hazardous drinking enrolled in the WHAT-IF? Study

Recruitment, experience, and retention among women with HIV and hazardous drinking enrolled in the WHAT-IF? Study

“I just keep quiet about it and act as if everything is alright” – The cascade from trauma to disengagement among adolescents living with HIV in western Kenya

Prevalence and Social-Structural Correlates of Gender-Based Violence Against Women Living With HIV in Metro Vancouver, Canada

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