HIV and Domestic Violence: Training to Improve HIV Risk Reduction Counseling, Testing, and Sexual Safety Planning with DV Survivors

Issues: Women domestic violence (DV) survivors are high risk for HIV, but have access issues for VCT because of DV and homelessness. HIV clinical programs (HCP) collaboration with DV/homeless agencies potentially reduces excess morbidity/mortality.

Description: Partnership between health education small business and HCP to provide 1) training and technical assistance around HIV/AIDS prevention, sexual safety planning (SSP), and VCT for DV agencies and homeless shelters (HS) and 2) DV training for health department PCRS and VCT programs. VCT provided by HCP and/or existing testing relationships. Year1: pilot program successfully implemented at 2 DV agencies (data presented at 2007 APHA) with citywide conference held at year's end to share results and recruit partners for Year2. Year2: Program expanded to other DV agencies, DV shelters, and to 2 HS serving women. Year1 curriculum/intervention continued with additional focus on homelessness issues and developing ways to identify DV survivors for referral for SSP and VCT.

Lessons Learned: HIV/AIDS baseline knowledge and SSP use in DV/homeless agencies is low but rises significantly with training. Sexual safety planning integrates well with DV safety planning, especially if incorporated into current practices. Women at general HS have high DV rates but unlikely to self-identify at intake, so effective screening methods to identify women for SSP needed. Agency evaluation acceptance improved by use of partner defined quality methods.

Recommendations: HCP relationships with DV and homeless agencies need to be expanded so that HIV prevention including SSP and VCT efforts can be maximized for this high risk for HIV population.