Tami Sullivan, PhD, Associate Professor of Psychiatry and Director of Family Violence Research and Programs, and Jaimie Meyer, MD, MS, Assistant Professor of Medicine and Assistant Clinical Professor of Nursing, have been awarded a new grant to study intimate partner violence among women living with HIV.
The new Research Project Grant (R01) from the National Institute of Mental Health totals over $3 million over five years. It will allow Sullivan and Meyer to evaluate how intimate partner violence (IPV) impacts HIV care engagement and medication adherence on a daily basis among women living with HIV.
Meyer is an infectious disease physician, whose research focuses on testing and implementing HIV interventions for women. Sullivan’s research is centered on individual- and system-level factors that affect the wellbeing of victims of IPV, with specific focus on daily processes and micro-longitudinal designs.
The grant presented an opportunity for the pair to come together at an intersection of their research interests, Meyer said.
“I think that one of the joys of this project is that Tami and I are passionate about similar, overlapping things but we come at it from different perspectives,” she added.
There are critical gaps in IPV-HIV research, including a lack of information on how IPV exposure impacts HIV care, they said. Prior HIV research has described the HIV care continuum — the steps of HIV medical care that people living with HIV go through from initial diagnosis to achieving the goal of viral suppression — and the way people do or don’t successfully engage in it. Research shows large drop-offs between each step along the continuum, and it’s Sullivan’s and Meyer’s hypothesis that some of those drop-offs are related to IPV and ongoing trauma that impact a person’s lived experience with HIV.
This work is set in the context of a national effort underway by the Centers for Disease Control and Prevention to “End the HIV Epidemic,” which also ties into their research goals of understanding what keeps or prevents people from being engaged in HIV care, Meyer said.
“If we understand what prevents women from successfully engaging in HIV care, then we can intervene. I hope that we’re able to identify actionable factors to make care more meaningful to women,” she said.
Sullivan and Meyer’s pilot data confirmed patterns of IPV influence on HIV care across the domains of abusive partners actively and passively interfering with care, women’s self-worth being so affected by IPV that they are not invested in their care, and women avoiding providers to evade IPV detection.
“Yet, no study has examined factors across these domains on a daily basis,” they said.
They also plan to enroll both cis- and transgender women, they said.
“We felt it was important to enroll both cis and trans women because gender is an identity and we want to be inclusive,” Meyer said. “Transwomen are disproportionately affected by HIV and may experience unique barriers to care engagement. We also think we’ll be able to identify areas of shared experience between cis- and trans-women.”
Sullivan and Meyer are collaborating closely with Ryan White-funded clinics across Connecticut, as well as the state Department of Public Health, to complete their project.
Sullivan and Meyer plan to enroll 315 IPV-exposed women living with HIV, both in and out of HIV care, to participate in two in-person interviews over a 6-month span, as well as 28 days of daily data collection. They plan to start enrolling by July 2020 at the earliest.