‘‘Now, I know my life is not over!’: Introduction and Adaptation of the RESPECT HIV Intervention, OraQuick, and Trauma-Informed Care for Female Victims of Non-Partner Sexual Violence in Haiti

Abstract

Introduction. In the Cite Soleil (CS) shantytown of Haiti, non-partner sexual violence (NPSV) is widespread, involves multiple assailants who do not use condoms and inflict intentional coital injuries. HIV prevalence in Haiti is 2.2%, CS HIV prevalence is 3.6% shame, guilt, self-blame and societal stigma impede access to HIV testing/treatment in a context of low confidentiality. In that context, NPSV victims often succumb to AIDS. Culturally adapted evidence-based HIV interventions (EBIs) can increase HIV awareness and reduce HIV risk. Methods. Following the ADAPT-ITT model, we used purposive sampling to recruit and interview key stakeholders (age 18 and older) in four focus groups (Victims and health providers, as part of adaptation of an EBI HIV (RESPECT) with an orally administered RAPID HIV antibody test (OraQuick) to increase HIV awareness and testing and to reduce HIV risk for NPSV victims (N=32, 8/focus group). We also introduced trauma-informed care (TIC) to address the post-assault trauma of NPSV victims. Stakeholders were introduced to RESPECT, participated in RESPECT role plays, interpreted OraQuick HIV screen results after viewing a demonstration of a sample collection, and provided feedback on TIC. ATLAS.ti facilitated thematic content analysis of focus group transcripts. Results: Participants unanimously (100%) reported that RESPECT, OraQuick, and TIC were acceptable, feasible, and useful for increasing HIV awareness, reducing shame, guilt, and trauma, and empowering NPSV victims to reduce the risk of HIV acquisition/transmission in future consensual relationships. Conclusion: Establishing the acceptability, feasibility and effectiveness of RESPECT, OraQuick, and TIC in CS is a crucial first step towards responding to the HIV prevention and trauma needs of NPSV victims. Keywords: RESPECT HIV intervention, Haitian girls and women, victims of non-partner sexual violence, Adaptation of evidence-based interventions, RAPID HIV testing.