Transforming primary care from disease management to genuine healing and empowerment: a powerful new model of trauma-informed primary care
Why Trauma Matters
Twenty years ago, UCSF created the first HIV program in the country designed to respond to the unique needs of women and girls with HIV. At the UCSF Women’s HIV Program (WHP) doctors, nurses, pharmacists, social workers and therapists all work together under one roof to coordinate the care of our patients.
Despite these services, many HIV+ women in our program were still faring poorly. Many of our patients failed their life-saving medications and far too may were dying. These same poor outcomes are seen across the country in programs for women living with HIV. We needed to understand what was missing from our primary care model in order to help our patients become safe, healthy and empowered. WHP recently undertook significant research to better understand the causes of treatment failure among women living with HIV.
Developing a Solution: Our Research Linking HIV & Trauma
Through our research, WHP saw that unaddressed trauma fuels all aspects of the HIV epidemic among women. Women who experience trauma are far more likely to be at risk for HIV. HIV+ women who experience ongoing abuse are four times more likely to fail their medications and almost twice as likely to die. Seeing the insidious, lifelong impact of trauma among our
patients was a huge epiphany for us. We saw that without directly addressing past trauma and ongoing abuse, we would not be able to help our patients heal. We found that no organizations had operationalized a holistic response to trauma in primary care. Without a model to use as a guide, WHP is taking the lead to create one based on input from the nation’s leading trauma experts.
Becoming a National Champion
We believe that this new model of trauma-informed primary care is very powerful. Developing and disseminating this model has implications beyond the 350,000 HIV+ women currently
living in the United States. The model can be scaled for use with the larger population of all women and girls in the United States and internationally who experience abuse, loss, neglect and community violence.
We seek to lead the effort to:
• Clarify the elements of trauma-informed primary care through building consensus among policymakers, experts and stakeholders in this field
• Coordinate demonstration and evaluation projects of trauma-informed primary care with HIV+ and HIV- women
• Develop advocacy, communications and funding strategies to facilitate the broad implementation of trauma-informed primary care for vulnerable populations of women and girls
in the United States and internationally