Data suggests that 55% of women with HIV (and 20% of men) have experienced or are currently experiencing intimate partner violence. Lifetime experience with domestic and sexual abuse also increases the risk of acquiring HIV by 3 times. People who are abusive seek out partners with vulnerabilities that they can exploit. Additionally, they work to create new vulnerabilities in their partners. This may include forcing or coercing someone to participate in activities that increase their risk of HIV, like using injection drugs or having unprotected sex. A common tactic of domestic abuse, sexual violence increases the chance that someone will contract HIV. Studies suggest that 25-50% of women who have experienced intimate partner violence have been forced to have sex with their partners. 

The consequences of this violence extend well beyond initial risk, affecting whether and how survivors can access life-saving care. HIV positive women who are also survivors of intimate partner violence are not connected to healthcare as quickly after their diagnosis as their peers who have not experienced violence. They are also less likely to receive antiretroviral therapy, and among those who start treatment, survivors are more likely to discontinue care prematurely or experience treatment failure. Some of the biggest barriers to treatment and support for HIV-positive survivors are rooted in the reality that having HIV continues to be very stigmatized. Shame, fear, or negative past experiences disclosing HIV status often prevent people from confiding in anyone, even those who might be able to help them, like healthcare providers and advocates. Abusive partners may systematically attack their partners’ self-worth, making them believe they don’t deserve care or support.

In many cases, difficulty accessing care is not simply about stigma or fear, but about direct interference from an abusive partner. Abusers often intervene and try to physically prevent their victims from accessing healthcare or maintaining relationships with people who might be able to support them. They may restrict their partner’s access to transportation, money and means of communication. They may also try to limit access to medication for treatment. In the face of this control, advocates play a vital role in helping survivors reclaim access to care and safety. Advocates can help survivors develop a safety plan that includes ways to access basic needs and stay connected to critical healthcare. 

While advocates help survivors navigate safety and access, healthcare providers also have a powerful opportunity to intervene. Survivors of domestic abuse are generally quite open to talking with their healthcare providers. In fact, studies show that a majority of survivors want to be asked directly (and privately) by their healthcare provider about the abuse they are experiencing. Clinicians can help by adopting a practice of screening for domestic abuse and providing universal education about abuse to all patients. This equips everyone with resources and tools to seek support or help a loved one who might need it. Disclosing to a healthcare provider helps survivors mitigate the negative impact that domestic abuse can have on both their physical and mental health. For survivors with HIV, this can be especially important as they are four times more likely to seek treatment for HIV if they’ve talked to their doctor about the abuse they’ve experienced.

This work cannot happen in isolation, which is why collaboration across service systems is so important. Beyond supporting survivors directly, advocates at New Hope Midcoast collaborate with partners in other social service organizations to respond to survivors they encounter through their work. We offer training in foundational information about domestic abuse, its impact on health, and how providers can screen for abuse and intervene effectively when they learn that a patient has been impacted by abuse. Our commitment to partnership and survivor-led care defines the work of New Hope Midcoast. To learn more about how New Hope supports victim-survivors of domestic abuse, visit www.newhopemidcoast.org. If you or someone you know is experiencing domestic abuse, call the New Hope Midcoast 24/7 helpline at 1-800-522-3304.

New Hope Midcoast is one of Maine’s Regional Domestic Violence Resource Centers and a member of the Maine Coalition to End Domestic Violence. The nonprofit organization supports people impacted by domestic abuse, dating violence and stalking through housing and legal advocacy, education and prevention programs, and a 24/7 helpline. The organization serves Sagadahoc, Lincoln, Knox and Waldo counties. New Hope continues to meet clients where they are and recognizes that the impact of domestic abuse is widespread. We are survivor-led and believe that, together, we can address social concerns that continue right here in our communities.