# An implementation science study of violence screening practices among Ryan White-funded sites in the Southeastern United States

> **NIH NIH R01** · EMORY UNIVERSITY · 2021 · $683,824

## Abstract

ABSTRACT
In the United States (US), 85% of people living with HIV (PLWH) are aware of their HIV status, but only 62% are
linked to HIV care and less than half (48%) are retained in care and virally suppressed (49%). Violence has been
increasingly recognized as a critical determinant of poor engagement along the HIV care continuum. For
example, histories of intimate partner violence and child abuse are common among PLWH. Further, in the
Southeast, the current epicenter of the national epidemic and a region plagued by persistent
homophobia/transphobia, racism, social conservatism and poverty, PLWH are more likely to also experience
hate crimes and other community violence. Thus, violence screening and intervention within HIV care is critical
to ending the HIV epidemic in the South. But, given the multi-dimensionality of violence experience (i.e. intimate
partner violence, child abuse, community violence including non-partner assault and hate crimes) and the
resource and time constraints of Ryan White-funded HIV Clinics (RWCs) and Ryan White-funded AIDS Service
Organizations (ASOs) who serve the bulk of PLWH, it is paramount to first determine which forms of violence
are experienced most frequently and have greatest impact on HIV outcomes. This insight could help RW
agencies prioritize violence screening and support services. Thus in, Aim 1, we comprehensively assess
violence experience (interpersonal & community) and its association with RW program indicators of retention in
care (% of patients with no medical visit in last 6 months of measurement year; % with medical visit every 6
months over 24-months) and viral suppression (% with HIV viral load <200 copies/ml) among 300 PLWH (men
and women, cis and transgender) from RWCs and ASOs in Metro Atlanta. Next, in response to the dearth of
evidence regarding preferences of PLWH for violence screening and to ensure violence screening does not
inadvertently re-traumatize survivors, in Aim 2, we conduct semi-structured interviews among a purposive
sample (n=75) of survey participants (men and women, cis and transgender PLWH, in and out of care) to
determine acceptability and preferences for violence screening (e.g., what, where, how, who) and support
services/treatment options that RWCs and ASOs could adopt. Lastly, in recognition of the need to integrate RW
agency stakeholder preferences and address provider, staff, and agency-level barriers to screening and support
service provision/referral for the process to be effective, in Aim 3, we conduct an explanatory sequential, mixed
methods assessment consisting of a regionally-targeted survey (N=600) and key informant interviews (n=60)
among administrators, staff and providers working in RWCs and ASOs in Atlanta and across the Southeast to
assess inner and outer setting factors that may influence adoption and implementation of (a) violence screening,
and (b) violence-relevant treatment/support. Findings will inform development of (1) key stakeholder-driven,
...

## Key facts

- **NIH application ID:** 10143309
- **Project number:** 5R01MH121962-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Ameeta Shivdas Kalokhe
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $683,824
- **Award type:** 5
- **Project period:** 2020-04-15 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10143309

## Citation

> US National Institutes of Health, RePORTER application 10143309, An implementation science study of violence screening practices among Ryan White-funded sites in the Southeastern United States (5R01MH121962-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10143309. Licensed CC0.

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