Trauma-Informed Decision-Making Among Providers and Victims of Intimate Partner Violence During HIV Testing: A Qualitative Study.
Jessica R Williams, Rosa M Gonzalez-Guarda, Vanessa Ilias
PMID 28526332WHAT IT FOUND
Women with a history of intimate partner violence described HIV testing as more acceptable when conducted in supportive, non-clinical settings.
Risk questions about sexual behavior were frequently re-traumatizing. Nurses should prioritize emotional support and consider co-locating testing with advocacy services.
Key findings
01Participants valued the comfort and support of testing at a family justice center over a hospital or clinic setting.
02Service providers noted that mandatory risk-behavior questions could feel insensitive and lead to re-victimization for women with a history of intimate partner violence.
03Fear of stigma and competing life priorities, such as housing and safety, often outweighed the perceived benefits of HIV testing for this population.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small (n=19) and drawn from a single urban center in the southeastern United States. Most women with a history of IPV in the sample (9 of 10) had previously received an HIV test, potentially skewing views toward those already engaged with healthcare. Participants were recruited from a domestic violence service agency, so the findings may not reflect the experiences of women who have not sought help for IPV. The study relies on self-reported perceptions and does not measure actual testing rates or clinical outcomes.
Declared interests
The study was conducted as an adjunct to an NIH-funded parent study (P60MD002266). The authors reported no real or perceived vested interests that could be construed as a conflict of interest.
The easy way to misread this
Do not interpret these themes as evidence that trauma-informed testing protocols increase HIV testing rates or improve clinical outcomes. This study describes patient and provider perceptions of the process; it does not measure efficacy or adoption rates.