Through our research and experience working with patients, WHP realized that trauma – defined as “an event, series of events, or set of circumstances [e.g., childhood and adult physical, sexual, and emotional abuse; neglect; loss; community violence; and structural violence such as racism and homophobia] that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects” – was the key determinant in the health and well-being of our patients.
Our patients in general are not dying from HIV, but rather from trauma, directly in the cases where our patients have been murdered, and indirectly through depression, suicide, and addiction. Among the general population, trauma is well-known to be the leading cause of illness, death and disability. For example, the seminal Adverse Childhood Events study found that people who had experienced four or more categories of childhood trauma were twice as likely to have adult heart, lung and liver disease; three times more likely to suffer from alcoholism and depression; eleven times for likely to have intravenous drug use; and fourteen times more likely to attempt suicide.
WHP is now focused on developing and evaluating a response to lifelong and recent trauma among women living with HIV and in becoming a national leader advocating for trauma to be addressed in the primary care of all people. We call this model of care “trauma-informed primary care.”
We believe that a new focus on trauma-informed primary care is incredibly powerful. It can transform the care of the 1.2 million people living with HIV in the U.S. and the far larger number of people affected by trauma in the U.S. and internationally.