HIV RISK IN OLDER ABUSED WOMEN RECEIVING EMERGENCY CARE

Columbia Univ New York Morningside, New York NY

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Abstract

Rates of sexually transmitted diseases (STDs) including HIV among women attending Emergency Departments (EDs) are higher than in populations of women seeking non-emergency treatment. Additionally, studies estimate that between 5% to 35% off all women who receive treatment in Eds are there because of an injury or problem resulting from intimate partner violence (IPV). Although Eds are often the principal source of medical care for low income women at high risk of STDs and IPV, the health care system has been slow to develop treatment approaches that attend to the co-occurrence of HIV and partner violence particularly among women older than 50. In order to develop interventions that will be effective in controlling the spread of HIV in this population qualitative research into the context of risk behaviors must take IPV into consideration. The proposed study will utilize focus groups and in-depth interviews to: (a) elicit cultural meanings, values, and beliefs related to IPV and HIV risk behaviors among older (i.e. ages 50-60) women seeking ED services, (b) explore how IPV and fear of this violence may be related to older women's abilities to negotiate safer sex practices with their primary partners, and (c) investigate the types of formal and informal support services sought and utilize by older abused women to cope with HIV risk and partner violence. In the first six months of Year 1, 36 women between the ages of 50-64 attending an ED who have recently experienced IPV will participate in focus groups. An additional 45 abused women of the same age cohort will participate in narrative interviews. Participants will be recruited from New York Methodist Hospital Emergency Department. Investigators from Social Intervention Group (SIG) at Columbia University School of Social Work will lead the study in consultation with New York Methodist Hospital. Findings will increase understanding of the contextual factors that may explain the relationships between IPV and HIV risk behaviors in older women. Consequently findings will inform assessment, referral, and treatment protocols used by ED staff to meet the diverse needs of women ages 50-64 who are at risk for partner violence and HIV and will inform the design of HIV prevention interventions for this cohort of women.