Skip to main content

Advertisement

SpringerLink
Log in

Trauma-Informed HIV Care Interventions: Towards a Holistic Approach

  • Behavioral-Bio-Medical Interface (RJ DiClemente and JL Brown, Section Editors)
  • Published:
Current HIV/AIDS Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The prevalence of trauma is higher among people living with HIV compared to the general population and people living without HIV. Trauma may be a major barrier in attaining HIV treatment outcomes, such as linkage to HIV care, engagement in HIV care, adherence to antiretroviral therapy (ART), and viral suppression. The purpose of this review was to highlight trauma-informed interventions that are geared towards improving treatment outcomes among people living with HIV.

Recent Findings

Recent studies suggest that a trauma-informed approach to developing interventions may help to improve treatment outcomes, such as engagement in care and adherence to ART. However, studies have also shown that depending on the operationalization of usual care, a trauma-informed approach may result in similar outcomes.

Summary

Very few studies have examined the impact of trauma-informed interventions on HIV care and treatment outcomes. Additional research is needed on the acceptability, feasibility, and efficacy of trauma-informed interventions among affected populations such as older adults, and racial/ethnic and sexual minorities living with HIV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as:  •• Of major importance

  1. Brezing C, Ferrara M, Freudenreich O. The syndemic illness of HIV and trauma: implications for a trauma-informed model of care. Psychosomatics. 2015;56(2):107–18. This review examined studies assessing living with HIV and trauma. The authors also proposed a “trauma-informed model of care”.

    Article  PubMed  Google Scholar 

  2. Cuca YP, Shumway M, Machtinger EL, Davis K, Khanna N, Cocohoba J, Dawson-Rose C. The association of trauma with the physical, behavioral, and social health of women living with HIV: pathways to guide trauma-informed health care interventions. Women’s Health Issues. 2019;29(5):376–84.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Adeagbo O, Carina H, Blandford A, McKendry R, Estcourt C, Seeley J, Shahmanesh M. Exploring people’s candidacy for mobile health–supported HIV testing and care services in rural KwaZulu-Natal, South Africa: qualitative study. J Med Internet Res. 2019;21(11):1–13.

    Article  Google Scholar 

  4. Adeagbo OA, Seeley J, Gumede D, Xulu S, Dlamini N, Luthuli M, Dreyer J, Herbst C, Cowan F, Chimbindi N, et al. Process evaluation of peer-to-peer delivery of HIV self-testing and sexual health information to support HIV prevention among youth in rural KwaZulu-Natal, South Africa: qualitative analysis. BMJ Open. 2022;12(2):e048780.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Piper KN, Brown LL, Tamler I, Kalokhe AS, Sales JM. Application of the consolidated framework for implementation research to facilitate delivery of trauma-informed HIV care. Ethn Dis. 2021;31(1):109.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV epidemic: a plan for the United States. JAMA. 2019;321(9):844–5.

    Article  PubMed  Google Scholar 

  7. APA Dictionary of Psychology [https://dictionary.apa.org/trauma]

  8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. VA: Arlington; 2013.

    Book  Google Scholar 

  9. Kalichman SC, Gore-Felton C, Benotsch E, Cage M, Rompa D. Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men. J Child Sex Abus. 2004;13(1):1–15.

    Article  PubMed  Google Scholar 

  10. Pence BW, Reif S, Whetten K, Leserman J, Stangl D, Swartz M, Thielman N, Mugavero MJ. Minorities, the poor, and survivors of abuse: HIV-infected patients in the US Deep South. South Med J. 2007;100(11):1114–22.

    Article  PubMed  Google Scholar 

  11. Nightingale VR, Sher TG, Mattson M, Thilges S, Hansen NB. The effects of traumatic stressors and HIV-related trauma symptoms on health and health related quality of life. AIDS Behav. 2011;15(8):1870–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Safren SA, Gershuny BS, Hendriksen E. Symptoms of posttraumatic stress and death anxiety in persons with HIV and medication adherence difficulties. AIDS Patient Care STDS. 2003;17(12):657–64.

    Article  PubMed  Google Scholar 

  13. Brown MJ, Nkwonta CA, Kaur A, James T, Conserve DF, Small BJ, Haley WE. “Psychologically and emotionally, it affects me ‘til this day”: exploration of childhood sexual abuse perspectives among older adults living with HIV in South Carolina. Aging Ment Health. 2021:1–6.

  14. McLean CP, Fitzgerald H. Treating posttraumatic stress symptoms among people living with HIV: a critical review of intervention trials. Curr Psychiatry Rep. 2016;18(9):83–3.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Olley BO, Zeier MD, Seedat S, Stein DJ. Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa. AIDS Care. 2005;17(5):550–7.

    Article  CAS  PubMed  Google Scholar 

  16. Piper KN, Schiff J, Riddick C, Getachew B, Farber EW, Kalokhe A, Sales JM. Barriers and facilitators to implementation of trauma support services at a large HIV treatment center in the Southern United States. AIDS Care. 2021;33(3):316–25.

    Article  PubMed  Google Scholar 

  17. Whetten K, Leserman J, Lowe K, Stangl D, Thielman N, Swartz M, Hanisch L, Van Scoyoc L. Prevalence of childhood sexual abuse and physical trauma in an HIV-positive sample from the Deep South. Am J Public Health. 2006;96(6):1028–30.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Machtinger EL, Wilson T, Haberer JE, Weiss DS. Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav. 2012;16(8):2091–100.

    Article  CAS  PubMed  Google Scholar 

  19. Cougle JR, Timpano KR, Sachs-Ericsson N, Keough ME, Riccardi CJ. Examining the unique relationships between anxiety disorders and childhood physical and sexual abuse in the National Comorbidity Survey-Replication. Psychiatry Res. 2010;177(1-2):150–5.

    Article  PubMed  Google Scholar 

  20. Sales JM, Swartzendruber A, Phillips AL. Trauma-informed HIV prevention and treatment. Curr HIV/AIDS Rep. 2016;13(6):374–82.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kalokhe AS, Paranjape A, Bell CE, Cardenas GA, Kuper T, Metsch LR, Del Rio C. Intimate partner violence among HIV-infected crack cocaine users. AIDS Patient Care STDs. 2012;26(4):234–40.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Stockman JK, Anderson KM, Tsuyuki K, Horvath KJ. LinkPositively. A trauma-informed peer navigation and social networking WebApp to improve HIV care among Black women affected by interpersonal violence. J Health Care Poor Underserved. 2021;32(2 Suppl):166–88. This study described the implementation of a culturally affirming app to improve HIV care among Black women in the USA who had been affected by interpersonal violence.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kamen C, Flores S, Taniguchi S, Khaylis A, Lee S, Koopman C, Gore-Felton C. Sexual minority status and trauma symptom severity in men living with HIV/AIDS. J Behav Med. 2012;35(1):38–46.

    Article  PubMed  Google Scholar 

  24. Sullivan KA, Messer LC, Quinlivan EB. Substance abuse, violence, and HIV/AIDS (SAVA) syndemic effects on viral suppression among HIV positive women of color. AIDS Patient Care STDs. 2015;29(S1):S42–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Meyer JP, Springer SA, Altice FL. Substance abuse, violence, and HIV in women: a literature review of the syndemic. J Women’s Health. 2011;20(7):991–1006.

    Article  Google Scholar 

  26. Golding JM. Intimate partner violence as a risk factor for mental disorders: a meta-analysis. J Fam Violence. 1999;14(2):99–132.

    Article  Google Scholar 

  27. Dillon G, Hussain R, Loxton D, Rahman S. Mental and physical health and intimate partner violence against women: a review of the literature. Int Journal Family Med. 2013;313909.

  28. LeGrand S, Reif S, Sullivan K, Murray K, Barlow ML, Whetten K. A review of recent literature on trauma among individuals living with HIV. Curr HIV/AIDS Rep. 2015;12(4):397–405. This review examined literature on trauma among people living with HIV.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Jewkes R, Dunkle K, Jama-Shai N, Gray G. Impact of exposure to intimate partner violence on CD4+ and CD8+ T cell decay in HIV infected women: longitudinal study. PLoS One. 2015;10(3):e0122001.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Schafer KR, Brant J, Gupta S, Thorpe J, Winstead-Derlega C, Pinkerton R, Laughon K, Ingersoll K, Dillingham R. Intimate partner violence: a predictor of worse HIV outcomes and engagement in care. AIDS Patient Care STDs. 2012;26(6):356–65.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Sales JM, Anderson KM, Kokubun CW. Application of the consolidated framework for implementation research to facilitate violence screening in HIV care settings: a review of the literature. Curr HIV/AIDS Rep. 2021;18(4):309–27.

    Article  PubMed  Google Scholar 

  32. DeCandia CJ, Guarino K, Clervil, R. Trauma-informed care and trauma-specific services: a comprehensive approach to trauma intervention. In Washington, D. C.; 2014. https://www.air.org/sites/default/files/downloads/report/Trauma-Informed%20Care%20White%20Paper_October%202014.pdf.

  33. Hopper EK, Bassuk EL, Olivet J. Shelter from the storm: trauma-informed care in homeless service settings. The Open Health Services and Policy Journal. 2010;3:80–100.

    Google Scholar 

  34. Substance Abuse and Mental Health Services Administraion: SAMHSA’s concept of trauma and guidance for a trauma-informed approach. 2014. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf.

  35. Tolou-Shams M, Dauria EF, Folk J, Shumway M, Marshall BD, Rizzo CJ, Messina N, Covington S, Haack LM, Chaffee T. VOICES: an efficacious trauma-informed, gender-responsive cannabis use intervention for justice and school-referred girls with lifetime substance use history. Drug Alcohol Depend. 2021;228:108934.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Bateman J, Henderson C, Kezelman C. Trauma-informed care and practice: towards a cultural shift in policy reform across mental health and human services in Australia. A national strategic direction. Mental Health Coordinating Council. 2013;4.

  37. K Hopper E, L Bassuk E, Olivet J. Shelter from the storm: trauma-informed care in homelessness services settings. Open Health Serv Policy J. 2010; 3(1).

  38. Morrissey JP, Jackson EW, Ellis AR, Amaro H, Brown VB, Najavits LM. Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatr Serv. 2005;56(10):1213–22.

    Article  PubMed  Google Scholar 

  39. Bloom SL, Farragher B. Restoring sanctuary: a new operating system for trauma-informed systems of care: Oxford University Press; 2013.

    Book  Google Scholar 

  40. Seedat S. Interventions to improve psychological functioning and health outcomes of HIV-infected individuals with a history of trauma or PTSD. Curr HIV/AIDS Reports. 2012;9(4):344–50.

    Article  Google Scholar 

  41. Anderson JC, Campbell JC, Farley JE. Interventions to address HIV and intimate partner violence in Sub-Saharan Africa: a review of the literature. J Assoc Nurses AIDS Care. 2013;24(4):383–90.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Harrison A, Newell ML, Imrie J, Hoddinott G. HIV prevention for South African youth: which interventions work? A systematic review of current evidence. BMC Public Health. 2010;10:102.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Sikkema KJ, Ranby KW, Meade CS, Hansen NB, Wilson PA, Kochman A. Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse. J Consult Clin Psychol. 2013;81(2):274–83.

    Article  PubMed  Google Scholar 

  44. Sikkema KJ, Mulawa MI, Robertson C, Watt MH, Ciya N, Stein DJ, Cherenack EM, Choi KW, Kombora M, Joska JA. Improving AIDS Care After Trauma (ImpACT): pilot outcomes of a coping intervention among HIV-infected women with sexual trauma in South Africa. AIDS Behav. 2018;22(3):1039–52. This study assessed PTSD symptoms, ART adherence, and care engagement after implementation of the ImpACT intervention.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Sikkema KJ, Choi KW, Robertson C, Knettel BA, Ciya N, Knippler ET, Watt MH, Joska JA. Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories. Eval Program Plann. 2018;68:148–56.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Donenberg GR, Fitts J, Ingabire C, Nsanzimana S, Fabri M, Emerson E, et al. Results of the Kigali Imbereheza Project: a 2-arm individually randomized trial of TI-CBT enhanced to address ART adherence and mental health for Rwandan youth living with HIV. J Acquir Immune Defic Syndr 2022. This study assessed ART adherence and mental health outcomes after implementing trauma-informed cognitive behavioral therapy among Rwandan youth living with HIV.

  47. Singer MC. AIDS and the health crisis of the U.S. urban poor: the perspective of critical medical anthropolgy. SocSciMed. 1994;39:931–48.

    CAS  Google Scholar 

  48. DiClemente RJ, Crosby R, Kegler MC. Emerging theories in health promotion practice and research: Wiley; 2009.

    Google Scholar 

  49. Goldhammer H, Marc LG, Chavis NS, Psihopaidas D, Massaquoi M, Cahill S, Nortrup E, Dawson Rose C, Meyers J, Mayer KH, et al. Interventions for addressing trauma among people with HIV: a narrative review. AIDS Care. 2021:1–10.

  50. Brown MJ, Nkwonta CA, Kaur A, James T, Haider MR, Weissman SB, Hansen NB, Heckman TG, Li X. Intervention program needs for older adults living with HIV who are childhood sexual abuse survivors. Aging Ment Health. 2021:1–7.

  51. Guarino KSP, Konnath K, Clervil R, Bassuk E. Trauma-informed organizational toolkit. MD: In. Rockville; 2009.

    Google Scholar 

  52. Key Ingredients for Successful Trauma-Informed Care Implementation. https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/atc-whitepaper-040616.pdf.

Download references

Funding

The current study was funded by the National Institute of Mental Health K01MH115794 awarded to MJB. OA is funded by the University of South Carolina Advanced Support Program for Innovative Research Excellence-I (ASPIRE—Grant No.: 115400-21-56809). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the University of South Carolina.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I, 435C, Columbia, SC, 29208, USA

    Monique J. Brown

  2. South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Monique J. Brown & Oluwafemi Adeagbo

  3. Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Monique J. Brown

  4. Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Monique J. Brown

  5. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Oluwafemi Adeagbo

  6. Department of Sociology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa

    Oluwafemi Adeagbo

Authors
  1. Monique J. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oluwafemi Adeagbo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monique J. Brown.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Behavioral-Bio-Medical Interface

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brown, M.J., Adeagbo, O. Trauma-Informed HIV Care Interventions: Towards a Holistic Approach. Curr HIV/AIDS Rep 19, 177–183 (2022). https://doi.org/10.1007/s11904-022-00603-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11904-022-00603-3

Keywords

Search

Navigation