Yale University

Feasibility of a Multi-Sector Collaboration to initiate PrEP Uptake among IPV-Exposed Women

Principle Investigator(s):

Funder: National Institute of Mental Health
Project period: 05/17/2016 - 05/16/2017
Grant Type: Research

Abstract Text:

Women who experienced intimate partner violence (IPV) are four times more likely to be infected with HIV compared to women in non-violent relationships. Recognizing the need to address HIV among IPV-exposed women, a U.S. Presidential Memorandum in 2012 created the Interagency Federal Working Group to focus on understanding the intersections of IPV and HIV. To date, their efforts have aimed to reduce HIV infections through enhancing women-controlled strategies available to IPV-exposed women. Pre-exposure prophylaxis (PrEP) may be an effective women-controlled strategy that might reduce HIV infections and improve safety for IPV-exposed women. PrEP is the most promising biomedical HIV prevention strategy to date; yet, acceptability of PrEP uptake among this high-risk population remains unclear. To reduce HIV risk among IPV-exposed women, a multi-sector approach for PrEP uptake and delivery may be appropriate. A multi-sector approach brings diverse sectors (e.g., health clinics, IPV organizations, PrEP providers) together to collectively reduce HIV risk. Current research on PrEP uptake and delivery overlooks the experiences of IPV-exposed women, and thus, is limited. PrEP is prescribed by healthcare providers and while IPV-exposed women are referred to and seek medical care from healthcare providers; many providers are neither trained in nor implement trauma-informed care. Further, IPV-exposed women often seek support from non-medical professionals such as IPV service organizations (i.e., shelters and counseling clinics). Since IPV service organizations have direct contact with IPV-exposed women, they could be key for PrEP delivery. Our study seeks to: (1) examine social and behavioral factors influencing PrEP uptake among IPV-exposed women; and (2) explore social, behavioral, and structural factors influencing a multi-sector PrEP collaboration between IPV service and healthcare providers. We will conduct quantitative interviews with 50 IPV-exposed women to explore factors that influence PrEP acceptability, and qualitative interviews with 8 IPV service organizations, 8 healthcare providers (i.e., OB/Gyn, ER), and 8 current PrEP providers to explore factors impacting PrEP implementation for IPV-exposed women, including organizational, inter-organizational, and provider-level factors.