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

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:

• Trauma-informed care
• HIV/AIDS
• trauma support services
• implementation

Acknowledgements

This study was funded by a developmental grant from the NIH Center for AIDS Research (P30AI050409). We also thank the treatment center for their dedication and continued support, as well as staff, providers, and administrators for their participation in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by a developmental grant from the Center for AIDS Research, Emory University [grant number P30AI050409].