Barriers and facilitators to implementation of trauma support services at a large HIV treatment center in the Southern United States

AIDS Care. 2021 Mar;33(3):316-325. doi: 10.1080/09540121.2020.1764473. Epub 2020 May 18.

Abstract

The high prevalence of trauma among people living with HIV underscore the need for tailored, integrated trauma management ("trauma-informed care" or TIC) to improve retention, adherence to care, and overall well-being. Although TIC has been identified as a priority area for HIV care, uptake has been limited. To investigate barriers and facilitators to integrating trauma support services within HIV primary care, surveys (n=94) and interviews (n=44) were administered to providers, staff, and patients at a large HIV treatment center. Results highlighted the availability of several trauma services, including psychotherapy and support groups, but also revealed the absence of provider training on how to respond to patient trauma needs. Identified gaps in TIC services included written safety and crisis prevention plans, patient education on traumatic stressors, and opportunities for creative expression. Providers and staff supported implementation of trauma support services and employee trainings, but expressed a number of concerns including resource and skill deficiencies. Patient-reported barriers to TIC services included lack of awareness of services and difficulties navigating the healthcare system. This assessment revealed support and methods for strengthening integration of trauma support services within HIV primary care, which future TIC implementation efforts should address.

Keywords: HIV/AIDS; Trauma-informed care; implementation; trauma support services.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Delivery of Health Care
  • Delivery of Health Care, Integrated
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Health Services Accessibility
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Primary Health Care / organization & administration*
  • Qualitative Research
  • Social Support*
  • Stress Disorders, Traumatic / psychology*
  • Stress Disorders, Traumatic / therapy
  • Surveys and Questionnaires
  • United States

Substances

  • Anti-HIV Agents