Violence and PTSD screening implementation in southeastern Ryan White settings: current practices and staff recommendations

Violence and post-traumatic stress disorder (PTSD) are highly prevalent among people with HIV (PWH) and have been linked to poor HIV care outcomes. Appropriate screening allows for linkage to support services demonstrated to improve HIV care outcomes yet remains understudied. Our objective was to understand violence and PTSD screening implementation among Ryan White HIV/AIDS Program (RWHAP) settings in the southeastern United States. In 2024, we conducted key informant interviews with 39 staff, providers, and administrators from 34 RWHAP clinics and community-based organizations across eight states. We used rapid qualitative analysis to identify current practices, barriers, and facilitators of violence/PTSD screening implementation. Violence/PTSD screening practices varied among RWHAP settings. About half of participants screened for intimate partner violence. Many perceived universal violence/PTSD screening as important and acceptable. Common implementation barriers included time constraints and staff burden; facilitators included using a brief screener, training staff (e.g., social workers) to conduct the screening, screening during intake, and having clear protocols for next steps (e.g., referrals). Future screening implementation efforts should include training staff, establishing clear follow-up processes, and minimizing time and staffing constraints. Aligning implementation strategies with staff recommendations would support trauma-informed approaches and may improve care outcomes and overall well-being for PWH.