Adverse Childhood Experiences at a HIV clinic in rural Appalachia: a pilot study to assess HIV/AIDS treatment barriers
Location
D.P. Culp Center Ballroom
Start Date
4-5-2024 9:00 AM
End Date
4-5-2024 11:30 AM
Poster Number
52
Name of Project's Faculty Sponsor
Megan Quinn
Faculty Sponsor's Department
Biostatistics and Epidemiology
Competition Type
Competitive
Type
Poster Presentation
Presentation Category
Health
Abstract or Artist's Statement
Southern Appalachia has the highest HIV prevalence compared to other parts of Appalachia, and persons living with HIV/AIDS (PLWH) have reported Adverse Childhood Experiences (ACEs) and substance abuse as reasons for not adhering to treatment. Trauma like ACEs are known to play a role in HIV risk behaviors, however, little information exists to aid healthcare providers in understanding how ACEs affect a patient’s readiness to receive and adhere to HIV treatment. The Center of Excellence for HIV/AIDS (COE) at East Tennessee State University treats patients from rural Appalachia with varying sociodemographic characteristics and trauma histories. Although the COE has a multidisciplinary healthcare team approach and provides financial and social support services to assist patients with quality of life, treatment adherence among patients is not always 100%. In order to aid the COE in overcoming barriers to HIV treatment adherence that may be related to ACEs in rural Appalachia, two standard ACE screeners from the World Health Organization and Behavioral Risk Factor Surveillance System (BRFSS) were used to create a new screener for the COE to assess ACEs, risks, and potential barriers to treatment that were not quantifiably known before. This screener was administered among COE patients to identify how ACEs are associated with perceived barriers to treatment adherence for HIV/AIDS. In rural southern Appalachia, HIV/AIDS is more prevalent compared to all other regions, and, when HIV prevalence is coupled with the opioid epidemic there is potential for HIV epidemics in these regions.1–3 ACEs such as household dysfunction and physical, emotional, or sexual abuse are also prevalent in rural Appalachia and while ACEs are known to be associated with health risk behaviors, overall evidence for HIV risk factors in relation to ACEs is limited.4 One study found that in the state of Tennessee, a person with four or more ACEs was eight times as likely to have HIV risk factors compared to adults with less than four ACEs. 4 However, few studies have examined a more comprehensive picture of PLWH to include perceived knowledge, attitudes, and beliefs and no studies have used a standard ACE screener in a HIV/AIDS clinic with patient feedback on the screening tool.5,6 This project will relied on perspectives of PLWH perspectives to understand barriers faced to treatment adherence through the development and administration of a modified ACE screener. Project Goals: To determine how ACEs are associated with perceived barriers and readiness to adhere to HIV/AIDS treatment for PLWH.
Adverse Childhood Experiences at a HIV clinic in rural Appalachia: a pilot study to assess HIV/AIDS treatment barriers
D.P. Culp Center Ballroom
Southern Appalachia has the highest HIV prevalence compared to other parts of Appalachia, and persons living with HIV/AIDS (PLWH) have reported Adverse Childhood Experiences (ACEs) and substance abuse as reasons for not adhering to treatment. Trauma like ACEs are known to play a role in HIV risk behaviors, however, little information exists to aid healthcare providers in understanding how ACEs affect a patient’s readiness to receive and adhere to HIV treatment. The Center of Excellence for HIV/AIDS (COE) at East Tennessee State University treats patients from rural Appalachia with varying sociodemographic characteristics and trauma histories. Although the COE has a multidisciplinary healthcare team approach and provides financial and social support services to assist patients with quality of life, treatment adherence among patients is not always 100%. In order to aid the COE in overcoming barriers to HIV treatment adherence that may be related to ACEs in rural Appalachia, two standard ACE screeners from the World Health Organization and Behavioral Risk Factor Surveillance System (BRFSS) were used to create a new screener for the COE to assess ACEs, risks, and potential barriers to treatment that were not quantifiably known before. This screener was administered among COE patients to identify how ACEs are associated with perceived barriers to treatment adherence for HIV/AIDS. In rural southern Appalachia, HIV/AIDS is more prevalent compared to all other regions, and, when HIV prevalence is coupled with the opioid epidemic there is potential for HIV epidemics in these regions.1–3 ACEs such as household dysfunction and physical, emotional, or sexual abuse are also prevalent in rural Appalachia and while ACEs are known to be associated with health risk behaviors, overall evidence for HIV risk factors in relation to ACEs is limited.4 One study found that in the state of Tennessee, a person with four or more ACEs was eight times as likely to have HIV risk factors compared to adults with less than four ACEs. 4 However, few studies have examined a more comprehensive picture of PLWH to include perceived knowledge, attitudes, and beliefs and no studies have used a standard ACE screener in a HIV/AIDS clinic with patient feedback on the screening tool.5,6 This project will relied on perspectives of PLWH perspectives to understand barriers faced to treatment adherence through the development and administration of a modified ACE screener. Project Goals: To determine how ACEs are associated with perceived barriers and readiness to adhere to HIV/AIDS treatment for PLWH.