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Publication Date


Document Type



School for Social Work


HIV-positive women-Psychology, HIV-positive women-Services for, Intimate partner violence-Psychological aspects, Intimate partner violence-Prevention, Stigma (Social psychology), Attachment disorder, Security (Psychology), Psychic trauma, HIV, IPV, Stigma, Attachment, Trauma


HIV and Intimate Partner Violence (IPV) are two serious public health crises that intersect and negatively affect women. This dissertation project used a mixed methods study design to explore and understand 1) what HIV-positive women need to end IPV in their lives, 2) the roles of HIV stigma and attachment insecurity in their experiences of IPV and living with HIV, and 3) what medical and social service providers can do to best support HIV-positive women to stop IPV in their lives. 108 HIV-positive women who receive medical care at the University of California San Francisco Women's HIV Program and San Francisco General Hospital Ward 86 were surveyed, and follow-up qualitative interviews were conducted with 15 survey participants. Quantitative findings showed that this was a repetitively traumatized study sample who were predominantly insecurely attached and had histories of substance abuse. Significant relationships were found between attachment insecurity and high levels of HIV stigma among participants, and qualitative results demonstrated that HIV stigma was a key factor in keeping women in IPV relationships; these results highlighted the importance of clinicians addressing the dual issues of HIV stigma and attachment insecurity when working with this population to stop IPV. Also, participants tended to access personal supports and the multiple services available at their medical clinics to end violent relationships instead of IPV specific resources. They described having trusted, long-term, familial relationships with their providers at UCSF and Ward 86. These relationships, along with HIV community, positive HIV disclosure experiences, and other factors such as spirituality, sobriety, and personal coping strategies were identified as helping to end IPV in their lives and/or cope with HIV. Also, participants suggested ways to improve IPV services at the clinics that included adding support groups and providers being proactive with patients who miss appointments and consistently screening for IPV.




v, 204 p. : col. ill. Dissertation (Ph.D.)--Smith College School for Social Work, 2013. Includes bibliographical references (p. 156-163)