Yvette P Cuca1, Martha Shumway2, Edward L Machtinger3, Katy Davis4, Naina Khanna5, Jennifer Cocohoba6, Carol Dawson-Rose7. 1. Department of Community Health Systems, UCSF School of Nursing, San Francisco, California. Electronic address: yvette.cuca@ucsf.edu. 2. UCSF School of Medicine, Department of Psychiatry, San Francisco, California. 3. UCSF Women's HIV Program, San Francisco, California; UCSF Center to Advance Trauma-informed Health Care, UCSF Department of Medicine, San Francisco, California. 4. UCSF Women's HIV Program, San Francisco, California. 5. Positive Women's Network-USA, Oakland, California. 6. UCSF Women's HIV Program, San Francisco, California; UCSF School of Pharmacy, San Francisco, California. 7. Department of Community Health Systems, UCSF School of Nursing, San Francisco, California.
Abstract
BACKGROUND: Trauma is increasingly recognized as a near-universal experience among women living with HIV (WLHIV) and a key contributor to HIV acquisition, morbidity, and mortality. METHODS: We present data from the baseline analysis of a planned intervention trial of the impact of trauma-informed health care on physical, behavioral, and social health outcomes of WLHIV in one clinic, with a particular focus on quality of life and viral suppression. Data were collected through interviewer-administered surveys and electronic health record data abstraction. RESULTS: Among 104 WLHIV, 97.1% of participants reported having experienced lifetime trauma, and participants had experienced on average 4.2 out of 10 Adverse Childhood Experiences. WLHIV with more lifetime trauma were significantly more likely to report post-traumatic stress disorder, depression, and anxiety symptoms; significantly more likely to report potentially harmful alcohol and drug use; and had a significantly poorer quality of life. In addition, women who had experienced more lifetime trauma were significantly less likely to report being on and adhering to HIV medications, although trauma was not significantly associated with having an undetectable HIV viral load. CONCLUSIONS: These data suggest that trauma is associated with much of the morbidity and mortality experienced by WLHIV. The results of this study support the implementation and study of trauma-informed approaches to health care for WLHIV.
BACKGROUND:Trauma is increasingly recognized as a near-universal experience among women living with HIV (WLHIV) and a key contributor to HIV acquisition, morbidity, and mortality. METHODS: We present data from the baseline analysis of a planned intervention trial of the impact of trauma-informed health care on physical, behavioral, and social health outcomes of WLHIV in one clinic, with a particular focus on quality of life and viral suppression. Data were collected through interviewer-administered surveys and electronic health record data abstraction. RESULTS: Among 104 WLHIV, 97.1% of participants reported having experienced lifetime trauma, and participants had experienced on average 4.2 out of 10 Adverse Childhood Experiences. WLHIV with more lifetime trauma were significantly more likely to report post-traumatic stress disorder, depression, and anxiety symptoms; significantly more likely to report potentially harmful alcohol and drug use; and had a significantly poorer quality of life. In addition, women who had experienced more lifetime trauma were significantly less likely to report being on and adhering to HIV medications, although trauma was not significantly associated with having an undetectable HIV viral load. CONCLUSIONS: These data suggest that trauma is associated with much of the morbidity and mortality experienced by WLHIV. The results of this study support the implementation and study of trauma-informed approaches to health care for WLHIV.
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