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Developing a Trauma Informed HIV Screening Process

A trauma-informed program, organization, system, or community is one that incorporates an understanding of the pervasiveness of trauma and its impact into every aspect of its practice or programs. In such settings, understanding of trauma is reflected in the knowledge, attitudes, and skills of individuals as well as in organizational structures such as policies, procedures, language, and supports for staff. This includes attending to culturally specific experiences of trauma and providing culturally relevant and linguistically appropriate services. It also includes recognizing that not only are the people being served potentially affected by trauma, but that staff members may be as well.

HIV in the United States is a public health crisis, disproportionately impacting communities who are already facing historical trauma, racism, homophobia and other forms of insidious trauma. Additionally, people living with HIV are more likely than the general population to have experienced a history of interpersonal violence. Across a number of studies, the rate of IPV among HIV-positive women (55%) was double the national rate, and the rates of childhood sexual abuse (39%) and childhood physical abuse (42%) were more than double the national rate (CDC, 2014).

Therefore, in both HIV/AIDS service organizations and domestic and sexual violence agencies, it is important to conduct screening for trauma, and provide support that understands the pervasiveness and impact of trauma, and works to alleviate trauma at all levels of the agency and agency processes. Below are resources to help agencies think about trauma-informed services and implement trauma-informed services using a variety of tools.

"...a recent study of HIV-positive women in clinical care published by Dr. Edward Machtinger of the University of California – San Francisco (UCSF). Machtinger’s study revealed evidence that recent trauma, defined as being abused, threatened, the victim of violence, or coerced to have sex in the last 30 days, was the single statistically significant predictor of anti- retroviral (ART) failure." - Khanna and Madoori, 2013