AIDS and Behavior

, 13:207 | Cite as

Long-Term Correlates of Childhood Abuse among Adults with Severe Mental Illness: Adult Victimization, Substance Abuse, and HIV Sexual Risk Behavior

  • Christina S. MeadeEmail author
  • Trace S. Kershaw
  • Nathan B. Hansen
  • Kathleen J. Sikkema
Original Paper


The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.


Severe mental illness HIV risk behavior Childhood abuse Substance abuse Revictimization 



This study was supported by grants F31-MH067370 and T32-DA01536 from the National Institutes of Health.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Christina S. Meade
    • 1
    • 2
    Email author
  • Trace S. Kershaw
    • 3
  • Nathan B. Hansen
    • 4
  • Kathleen J. Sikkema
    • 1
    • 4
    • 5
  1. 1.Department of PsychologyYale UniversityNew HavenUSA
  2. 2.Department of PsychiatryMcLean Hospital/Harvard Medical SchoolBelmontUSA
  3. 3.Yale School of Public HealthYale UniversityNew HavenUSA
  4. 4.Department of PsychiatryYale University School of MedicineNew HavenUSA
  5. 5.Duke University School of NursingDurhamUSA

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