Implementing an Intimate Partner Violence (IPV) Screening Protocol in HIV Care

Abstract

HIV and intimate partner violence (IPV) epidemics propagate and interact in a syndemic fashion contributing to excess burden of disease and poorer health outcomes. In order to understand the impact of IPV on HIV disease management, a universal screening program was implemented in the Southern Alberta Clinic in May 2009. We evaluated our IPV screening protocol and made recommendations for its usage in HIV care. IPV data obtained from patients were evaluated, supplemented with responses from a subset of in-depth interviews. 35% of 1721 patients reported experiencing IPV. Prevalence was higher among females (46%), Aboriginal Canadians (67%), bisexual male/females (48%), and gay males (35%). Of 158 patients interviewed, only 22% had previously been asked about IPV in any health care setting. Patients were responsive to routine IPV screening emphasizing that referral services need to be easily accessible. 23% of patients disclosing IPV subsequently connected to additional IPV resources after screening. We recommend that universal IPV screening be incorporated within regular HIV clinic care. The IPV survey should be given after trust has been established with regular follow-up every 6-12 months. A referral process to local agencies dealing with IPV must be in place for patients disclosing abuses.

Intimate Partner Violence Experiences Among Men Living with HIV in Rural Appalachia

“…We found that more than one-third of participants (39.0%) experienced IPV in the past year. This overall IPV exposure rate is similar to prior studies in persons living with HIV, which utilized different assessment tools [36, 39, 53, 65]. The majority of participants in our study had a predominant HIV risk factor of male-to-male sexual contact.…”

“…This phenomenon of mutual IPV has been observed in the context of heterosexual and same-sex relationships, including those of people living with HIV [52], which likely reflects additional complexities within this syndemic that have yet to be explored. In response to these findings, many HIV providers are implementing IPV screening protocols within their clinics in an effort to better identify and assist these individuals [53].…”

“It’s Always Good to Ask”: A Mixed Methods Study on the Perceived Role of Sexual Health Practitioners Asking Gay and Bisexual Men About Experiences of Domestic Violence and Abuse

“…Health advisors were identified as the best placed practitioners to ask about DVA because they provide counseling in relation to risk behaviors such as unsafe sex, alcohol and substance abuse, and depression, all of which can co-occur with DVA (Buller, Devries, et al, 2014). Furthermore, they have time to develop a trusting relationship with patients, which can facilitate disclosure of abuse, a finding which has been reported in a Canadian study of a screening protocol for intimate partner violence in a HIV clinic (Raissi, Krentz, Siemieniuk, & Gill, 2015).…”

“…Furthermore, they have time to develop a trusting relationship with patients which can facilitate disclosure of abuse, a finding which has been reported in a Canadian study of a screening protocol for intimate partner violence in an HIV clinic (Raissi et al 2015). The interpersonal skills of the health practitioner was considered more important than gender or sexual orientation.…”

Improving the healthcare response to domestic violence and abuse in primary care: protocol for a mixed method evaluation of the implementation of a complex intervention

“…These guideline recommendations are based on research from multiple health settings. This research includes how to effectively identify those affected by DVA and record DVA safely, in emergency care [ 3 ], antenatal [ 4 ], maternity & sexual health services [ 5 ], HIV clinics [ 6 ], community gynaecology [ 7 ], mental health [ 8 ] and primary care [ 9 ]. Yet globally, clinicians often do not respond adequately to DVA [ 10 ].…”