Patient preferences for violence screening in HIV care settings

Area of Science:

• Public Health
• HIV Medicine
• Trauma-Informed Care

Background:

• Interpersonal and community violence are prevalent among people with HIV (PWH).
• Violence exposure is linked to adverse health outcomes in PWH.
• Implementing violence screening and support within HIV care is crucial.

Purpose of the Study:

• To explore the preferences of PWH regarding the integration of violence screening into HIV care.
• To inform the implementation of effective violence screening protocols in HIV services.
• To identify optimal methods for screening, including format, environment, and frequency.

Main Methods:

• Conducted 64 in-depth interviews with diverse PWH in Atlanta, Georgia (February-December 2022).
• Purposively selected participants based on gender, race/ethnicity, violence history, HIV viral suppression, and retention status.
• Explored themes of acceptability, screening modalities (in-person, paper, computer), item phrasing, provider, setting, timing, and frequency.

Main Results:

• Violence screening within HIV care was found to be highly acceptable and desirable among PWH.
• Participants preferred initiating screening at the first HIV care visit and regular follow-ups.
• Preferred screening method involved in-person, trauma-informed, conversational approaches by healthcare providers, with telehealth/computerized options for broader needs.

Conclusions:

• Integrating violence screening into HIV care is feasible and desired by PWH.
• A hybrid approach combining in-person, provider-led screening with supplementary digital tools best meets diverse patient needs.
• Findings provide essential evidence for developing national HIV care guidelines on violence screening.