WED-013 - Screening for Post-traumatic Stress Disorder: Implications for Workforce Development Along the HIV Care Continuum

Brief Abstract Summary: Learn about post-traumatic stress disorder (PTSD) screening within the HIV care continuum. Specifically, gain an in-depth understanding of potentially acceptable and feasible ways to implement universal PTSD screening in HIV care spaces. After interviewing 31 clinicians, staff, and administrators from Ryan White-funded clinics (RWCs) and HIV community-based organizations (CBOs) across eight states in the US South, we found that non-mental healthcare professionals, including clinical providers, nurses, medical assistants, and case managers, would be acceptable to conduct PTSD screening among people living with HIV (PLWH). Short PTSD screeners could make implementation more feasible. Increasing screening capacity within RWCs and CBOs may help facilitate referrals to trauma support services for PLWH. Health education and training programs for non-mental healthcare professionals should consider building PTSD screening skills among those working in HIV care settings.

Detailed abstract description:

Objective: Evidence suggests post-traumatic stress disorder (PTSD) is highly prevalent among people living with HIV (PLWH), many of whom could benefit from supportive services. PTSD screening is the first step to connecting individuals with the trauma-related support services they may need. However, little is known about PTSD screening practices in HIV care settings. We sought to understand current practices, feasibility, and acceptability of screening PLWH for PTSD in Ryan White-funded clinics (RWCs) and HIV community-based organizations (CBOs).

Methods: As part of a larger mixed methods study, we conducted key informant interviews with 31 clinicians, staff, and administrators at RWCs and CBOs across eight states in the Southeastern U.S. from Jan.-June 2024. In line with rapid analysis techniques for qualitative data, we constructed matrices using Microsoft Excel to identify salient themes across interviews.

Results: Most participants’ organizations did not practice universal PTSD screening. Among the few that did, mental health counselors or social workers usually conducted the screening. While nearly all participants indicated that screening all PLWH for PTSD would be acceptable, about half believed it would be difficult to implement due to time and staffing constraints. To increase feasibility of universal PTSD screening, participants suggested training other healthcare workers to conduct the screening (e.g., clinical providers, nurses, medical assistants, case managers, and other non-specialists). PTSD screening may be compatible with these individuals’ current responsibilities and workflow, as they may conduct other assessments (e.g., depression) already. Ensuring PTSD screening is not time-consuming or burdensome may help facilitate implementation. While a few participants also suggested having PLWH self-screen for PTSD (e.g., via electronic form) , several were concerned about poor health literacy. To overcome this challenge, participants emphasized the importance of using plain language and/or having a staff member on standby in case patients/clients need help. Overall, conducting PTSD screening could trigger referral processes and/or higher-level care as needed.

Conclusion: PTSD screening conducted by non-mental healthcare professionals may be acceptable to RWCs/CBOs and facilitate linkage to trauma support services among PLWH, which may further improve overall well-being and HIV clinical outcomes. Health education and training programs for these individuals should consider allocating training and resources to PTSD screening, especially for those working within the HIV care continuum.