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


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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    ABSTRACT: High rates of childhood maltreatment have been documented in HIV-positive men and women. In addition, mental disorders are highly prevalent in both HIV-infected individuals and victims of childhood maltreatment. However, there is a paucity of research investigating the mental health outcomes associated with childhood maltreatment in the context of HIV infection. The present systematic review assessed mental health outcomes in HIV-positive individuals who were victims of childhood maltreatment. A systematic search of all retrospective, prospective, or clinical trial studies assessing mental health outcomes associated with HIV and childhood maltreatment. The following online databases were searched on 25-31 August 2010: PubMed, Social Science Citation Index, and the Cochrane Library (the Cochrane Central Register of Controlled Trials and the Cochrane Developmental, Psychosocial and Learning Problems, HIV/AIDS, and Depression, Anxiety and Neurosis registers). We identified 34 studies suitable for inclusion. A total of 14,935 participants were included in these studies. A variety of mixed mental health outcomes were reported. The most commonly reported psychiatric disorders among HIV-positive individuals with a history of childhood maltreatment included: substance abuse, major depressive disorder, and posttraumatic stress disorder. An association between childhood maltreatment and poor adherence to antiretroviral regimens was also reported in some studies. A broad range of adult psychopathology has been reported in studies of HIV-infected individuals with a history of childhood maltreatment. However, a direct causal link cannot be well established. Longer term assessment will better delineate the nature, severity, and temporal relationship of childhood maltreatment to mental health outcomes.
    Systematic Reviews 06/2012; 1(1):30. DOI:10.1186/2046-4053-1-30
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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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    ABSTRACT: Experiences of past and current gender-based violence are common among HIV-positive women in the United States, who are predominantly from ethnic minority groups. However, culturally congruent, feasible interventions for HIV-positive women who have experienced past and/or current violence are not widely available. The Office on Women's Health Gender Forum has made several recommendations for responding to the National HIV/AIDS Strategy Implementation Plan, including recommendations to incorporate gender-based violence prevention into a comprehensive, gender-responsive national strategy. This paper draws on an example of a community-based project for HIV-positive women, the Healing Our Women Project, to illustrate how violence prevention can be achieved within peer-led and community-based programming. Strong community partnerships, responsiveness to community needs and local cultural norms, a trained workforce, and culturally competent care are programmatic cornerstones of gender-responsive services. HIV-positive women with histories of gender-based violence and risk factors for current and future violence deserve the highest quality gender-responsive services to ensure that they can address their health needs within contexts of safety and respect.
    Women s Health Issues 11/2011; 21(6 Suppl):S255-60. DOI:10.1016/j.whi.2011.07.007 · 1.61 Impact Factor
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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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    ABSTRACT: In this article we explore the lives of young women living with HIV who experienced physical and/or sexual abuse in childhood. Using a modified version of the Life Story Interview, 40 women recruited from HIV clinics in three different states participated in a qualitative interview. Interviews covered abuse experiences, cognitive and emotional consequences of abuse, coping strategies, and sexual behavior and relationships. Overall, these young women had complex abuse histories, often experiencing more than one type of abuse in the context of other difficult life events. Avoidance and substance use were frequently utilized as coping strategies for abuse-related distress. Young women reported sexual and relationship concerns, including avoidance of sex, sexual dysfunction, sex as a trigger for abuse memories, and difficulty establishing intimacy and trust. Relationships between abuse-related reactions and sexual risk behavior, as well as recommendations for interventions, are discussed.
    Qualitative Health Research 12/2009; 19(12):1755-68. DOI:10.1177/1049732309353418 · 2.19 Impact Factor
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