Healthcare providers’ perspectives on integrating trauma-informed care for intimate partner violence in HIV/STI clinical settings in Trinidad and Tobago

Le résumé fourni par la source

Intimate Partner Violence (IPV) remains a significant public health concern, particularly for persons living with HIV (PLHIV) and other sexually transmitted infections (STIs). The intersection of IPV and HIV/STIs creates complex care needs requiring trauma-informed, contextually grounded responses. This study explored healthcare practitioners' perspectives on existing practices and opportunities to strengthen IPV-related care in public HIV/STI clinical settings in Trinidad and Tobago. Structured weekly consultations were conducted over seven weeks with 13 healthcare practitioners-including physicians, nurses, psychologists, social workers, and peers living with HIV-across five public HIV/STI clinics. Guided by national clinical protocols, discussions explored current practices, care gaps, and system-level challenges. Trauma-Informed Care (TIC) was examined through four core assumptions: realizing the impact of trauma, recognizing its signs, responding appropriately, and resisting re-traumatization. Practitioners also considered how TIC could be integrated along the care pathway at five key points: awareness, identification, first-line response, survivor-centered care, and inter-agency referral. Participants identified critical system-level gaps, including the lack of standardized IPV protocols, limited documentation, concerns about privacy, fragmented referral systems, and stigma related to both HIV and IPV. Time constraints and limited training were cited as barriers to consistent, high-quality care. Practitioners also highlighted the elevated vulnerability of women, youth living with HIV, and men who have sex with men to IPV. There was strong consensus on the need for structured TIC training for all levels of staff. The findings underscore urgent opportunities to enhance clinical responses to IPV through the integration of trauma-informed care along the HIV/STI service pathway. Prioritizing TIC can improve care quality, reduce re-traumatization, and strengthen engagement and resilience among populations most at risk.

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