A trauma-informed approach to increase HIV prevention and care engagement in a population with elevated HIV burden

PROJECT SUMMARY/ABSTRACT Despite decades of HIV research, differences in rates of prevention and treatment engagement persist, particularly among populations facing significant barriers to care. Trauma, exposure to violence, and related mental health conditions such as post-traumatic stress disorder may impact individual’s ability to initiate and engage in HIV services. To help end the HIV epidemic, there is a need for interventions that improve PrEP uptake and viral suppression among populations with high-risk. The goal of the K23 award is to pilot a trauma-informed approach to increase HIV prevention and care engagement in a community clinic serving high-risk populations. This proposal includes three aims to achieve this goal. Aim 1 will examine how trauma and mental health influence HIV prevention and care engagement, using in-depth interview with 20 participants who face significant barriers to care. Aim 2 examines barriers and facilitators to implementing a trauma screener, brief intervention, and referral to treatment (T-SBIRT) in community clinics using in-depth interviews with 20 clinic stakeholders (e.g., leadership, health care providers, staff). Aim 3 will pilot test T-SBIRT with 50 participants in a community clinic to assess implementation outcomes. The intervention will be guided by an enhanced Consolidated Framework for Implementation Research. These specific aims will be achieved by the following training aims: 1) build content expertise on trauma stressors, mental health, and T-SBIRT, 2) develop methodological skills in clinical trials and intervention development, and 3) gain core competencies in implementation science. These objectives will be guided by a cross-disciplinary mentoring team with expertise in trauma, mental health, and implementation science. Findings from this research will generate data that will inform a future R01 proposal at scaling the T-SBIRT intervention across multiple clinics.