Patient preferences for violence screening in HIV care settings.

Abstract

Experiences of interpersonal- and community-level violence are common among people with HIV (PWH) and associated with poor health outcomes, underscoring a need to implement violence screening and support in HIV care. To inform this implementation, we explored preferences of PWH regarding integration of violence screening into HIV care. From February-December 2022, 64 in-depth interviews were conducted with PWH in Atlanta, Georgia as part of a larger mixed-methods study. Participants were purposively selected for diversity of gender, race/ethnicity, violence exposure history, HIV viral suppression, and retention in care. Themes explored included acceptability of violence screening in HIV care and preferences for doing so (in-person, paper-pencil, computerized), screening item phrasing, screening environment (by whom, where), timing of initial screen, and screening frequency. Violence screening in HIV care was highly acceptable and desirable. Collectively, preference was voiced for initiating screening at first HIV care visit and conducting screening regularly thereafter, in-person, by healthcare providers in a trauma-informed, conversational manner, with supplementation by telehealth or computerized comprehensive screeners to accommodate a variety of needs. This study, the first to detail preferences of PWH across gender and retention/viral suppression status, fills a key gap in evidence informing violence screening recommendations in national HIV care guidelines.