Article

Severity of Child Sexual Abuse, Post- Traumatic Stress and Risky Sexual Behaviors Among HIV-Positive Women

Department of Psychology, University of California-Los Angeles, Los Angeles, CA 90095, USA.
AIDS and Behavior (Impact Factor: 3.49). 04/2006; 10(2):191-9. DOI: 10.1007/s10461-005-9054-6
Source: PubMed

ABSTRACT Child sexual abuse (CSA) has been shown to enhance risk for HIV infection and other adverse outcomes. However, most studies examine the effects of a single incident of CSA rather than the full burden of abuse over the life span in predicting these adverse outcomes. A multi-dimensional approach was used in this study to examine the severity of abuse as a predictor of post-traumatic stress, depression, sexual symptoms, and risky sexual behaviors in a multi-ethnic sample of 147 HIV-positive women. Multivariate models indicated that experiencing both intrafamilial and extrafamilial CSA, adult sexual abuse (ASA) and Latina ethnicity predicted PTSD symptoms. ASA also predicted sexual trauma symptoms. Also, CSA and adult re-victimization contributed independently to risk for PTSD and sexual trauma symptoms, but not for risky sexual behaviors. The results support the need for interventions for HIV-positive women that address the full burden of abuse experienced and its sequelae.

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    • "In comparison to the general population (i.e. uninfected and non-abused counterparts), evidence suggests that ongoing risk behaviors and rates of psychopathology are higher in HIV-infected individuals with histories of abuse [7,8,10,31,37,53]. HIV-positive individuals were more likely to report posttraumatic stress, risky health behaviors, substance abuse, chronic stress, and psychiatric history compared with HIV-negative counterparts [53]. "
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    • "The goals of the " Healing Our Women " (HOW) Project were to 1) reduce psychological symptoms including depression, posttraumatic stress disorder (PTSD), and sexual trauma symptoms (e.g., unwanted sexual thoughts or feelings; Myers, et al., 2006; Briere, Elliott, Harris, & Cotman, 2003; see Table 3 for outcome measures); 2) address gender, culture, and the context of sexual risk taking (Raj, Silverman, & Amaro, 2004; Wyatt, 1994); and 3) achieve the above in partnership with community-based organizations (CBOs) that have limited training, staff shortages, and high turnover (Veniegas, Kao, Rosales, & Arellanes, 2009). There was recognition throughout the project that participants were likely to have experienced multiple forms of violence in their lives, so we considered violence prevention (i.e., prevention of revictimization, or secondary prevention) to be an inherent theme in the project. "
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    • "In addition to these outcomes, multiple studies have provided evidence that abuse experiences are associated with engagement in sexual and other risk behaviors (El-Bassel, Gilbert, Rajah, Foleno, & Frye, 2000; Myers et al., 2006; National Institute of Mental Health Multisite HIV Prevention Trial Group [NIMH MHPTG], 2001; Wilson and Widom, 2008). For example, in the Women's Interagency HIV Study, a history of child sexual abuse was associated with HIV risk behaviors, including lifetime history of drug use; being with a partner at risk for HIV; having more than 10 lifetime male partners; trading sex for money, drugs, or shelter; and being forced to have sex with an HIV-positive partner (Cohen et al., 2000). "
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