Journal of
AIDS and HIV Research

  • Abbreviation: J. AIDS HIV Res.
  • Language: English
  • ISSN: 2141-2359
  • DOI: 10.5897/JAHR
  • Start Year: 2009
  • Published Articles: 290

Full Length Research Paper

Development and integration of IPV-4, a patient-reported screening instrument of intimate partner violence for primary and HIV care

Rob Fredericksen
  • Rob Fredericksen
  • Department of Medicine, University of Washington, United States.
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Emma Fitzsimmons
  • Emma Fitzsimmons
  • Department of Medicine, University of Washington, United States.
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Sonia Avendano-Soto
  • Sonia Avendano-Soto
  • Department of Medicine, University of California-San Diego, United States.
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Sharon Brown
  • Sharon Brown
  • Department of Medicine, University of Washington, United States.
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Katerina Christopoulos
  • Katerina Christopoulos
  • Department of Medicine, University of California-San Francisco, United States.
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Sarah Dougherty
  • Sarah Dougherty
  • Department of Medicine, University of Alabama-Birmingham, United States.
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Joseph Eron
  • Joseph Eron
  • Gillings School of Global Public Health, University of North Carolina, United States.
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Mari Kitahata
  • Mari Kitahata
  • Department of Medicine, University of Washington, United States.
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Stephanie Loo
  • Stephanie Loo
  • Fenway Community Health, United States.
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Kenneth Mayer
  • Kenneth Mayer
  • Fenway Community Health, United States.
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Michael Mugavero
  • Michael Mugavero
  • Department of Medicine, University of Alabama-Birmingham, United States.
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Sonia Napravnik
  • Sonia Napravnik
  • Gillings School of Global Public Health, University of North Carolina, United States.
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Conall O’Cleirigh
  • Conall O’Cleirigh
  • Fenway Community Health, United States.
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Jennifer Potter
  • Jennifer Potter
  • Fenway Community Health, United States.
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Stephanie Ruderman
  • Stephanie Ruderman
  • Department of Medicine, University of Washington, United States.
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Laurie Smith
  • Laurie Smith
  • Department of Medicine, University of Washington, United States.
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Paul Crane
  • Paul Crane
  • Department of Medicine, University of Washington, United States.
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Heidi Crane
  • Heidi Crane
  • Department of Medicine, University of Washington, United States.
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  •  Received: 13 September 2022
  •  Accepted: 08 November 2022
  •  Published: 31 December 2022

Abstract

Intimate partner violence (IPV) is a significant and under-reported health problem. Legacy measures of IPV lack brevity and/or are relevant only to specific populations, which limit their usefulness for routine clinical care. We developed a brief patient-reported screening instrument of past-year intimate partner violence (IPV). We developed an item pool from validated IPV screening instruments,  dimensionalized and winnowed its content to select candidate items. We conducted interviews with English and Spanish-speaking persons in HIV care in six U.S. primary care clinics to assess their comprehensibility, which informed the development of the four-item instrument (IPV-4).  After integration into care we performed chart review for indication of  IPV in the past 5 years to assess impact. We identified 68 items from 12 instruments and winnowed content within dimensions of physical, sexual, and psychological violence. We then presented 11 candidate items to PWH in interviews (n=45, 49% Spanish-language; mean age 45 years; 62% cisgender male, 33% cisgender female, 5% transgender female; 71% nonwhite). The resulting instrument was well-understood in English and Spanish and relevant across gender and sexual orientation. PWH (n=6415) completed the IPV-4 in clinical care settings; 9% reported any type of IPV and 5% reported physical and/or sexual violence. In chart notes of a single-site subset of PWH (n=1756), of those indicating physical and/or sexual violence on the IPV-4 with medical records available from the past five years (n=63), only 19% of PWH had prior notes indicating IPV in that time  period. The IPV-4 is a brief, gender/sexual orientation-neutral, clinically relevant screening instrumentthat identifies and dimensionalizes past-year IPV present in 9% of PWH in routine care.

Key words: HIV care, intimate partner violence, patient-reported outcome measures.