Patients' Positive Experiences and the Role of Agency and Respect in Supporting HIV Treatment and Care Outcomes Among Women Living With HIV: Implications for Trauma- and Violence-Informed HIV Care and Practice From a Longitudinal Cohort Study.

Abstract

ObjectiveWe examined the association between 18 covariates measuring women's self-reported positive experiences with their main HIV care provider/clinics, drawing on the Substance Abuse and Mental Health Services Administration "trauma-informed care" framework, and multiple HIV treatment/care outcomes.MethodsData (2014-2021) were drawn from a longitudinal community-based cohort with women living with HIV in Metro Vancouver (the Sexual Health and HIV/AIDS: Longitudinal Women's Needs Assessment) and analyzed using multivariable logistic regression with generalized estimating equations.ResultsMultivariable analysis suggested that principles of "safety and respect" (eg, feeling safe discussing sexual and/or reproductive health, confidentiality) and "strength-based collaboration" (eg, agency in scheduling, actively participating in one's own care) were significantly associated with higher odds of optimal HIV treatment/care outcomes.ConclusionsOur study provides evidence for the benefit of incorporating and scaling up education, training and health systems policies that support women's positive experiences with their main HIV care provider/clinics in a trauma- and violence-informed framework.