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Trauma-Informed Approaches and HIV

Trauma is defined as an event or circumstance that is “experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being.” Traumatic experiences that occur during childhood, also known as adverse childhood experiences, impact adult well-being and may lead to increased risk of depression, substance use, and health outcomes such as obesity.

People living with HIV may experience, or have experienced, physical and/or sexual abuse and/or intimate partner violence, with approximately 30% of people living with HIV experiencing trauma during childhood and close to 70% experiencing some form of intimate partner violence as an adult. These traumatic experiences impact health as well as receipt of medical services and may increase behaviors that put people at risk for HIV. For example, HIV-positive women who experience trauma are less likely to be virally suppressed and may not adhere to treatment regimens; they are also more likely to participate in riskier sexual activities.

Since people living with HIV are more likely to report having experienced trauma, it is important for organizations developing treatment and prevention programs to implement practices that are trauma-informed. Programs that are trauma-informed deliver services and use strategies that take into account the impact of trauma on the lives of individuals. The National Alliance of State and Territorial AIDS Directors (NASTAD) developed the Trauma-Informed Approaches Toolkit that outlines steps organizations can take to adapt HIV services to make them trauma-informed. In particular, Ryan White-funded HIV programs are important settings for trauma-informed care, since many people with HIV receive care through these settings, including mental health, substance use, and other social services.

Resources to Learn More

Trauma-Informed Approach: Improving Care for People Living with HIV Curriculum Trainer's Manual
Provides introductory training about trauma and trauma-informed approaches when offering care and support for people living with HIV. Includes Instructor Guidance, slides, short videos, and exercises that can be tailored as needed.
Organization(s): Substance Abuse and Mental Health Services Administration (SAMHSA)
Date: 2018