AIDS and Behavior

, Volume 15, Issue 1, pp 172–178 | Cite as

History of Sexual Trauma and Recent HIV-Risk Behaviors of Community-Recruited Substance Using Women

  • Sharon D. Johnson
  • Linda B. Cottler
  • Arbi Ben Abdallah
  • Catina Callahan O’Leary
Original Paper


This study examines whether substance using women exposed to a lifetime sexual trauma (n = 457) are distinguishable from substance using women exposed to non-sexual trauma (n = 275) in terms of demographics, psychopathology and high-risk sexual behaviors. Baseline data were collected from out-of-treatment substance using women enrolled in an HIV prevention study. Logistic regression analyses revealed that when demographics, psychopathology and lifetime indicators of sexual risk were assessed simultaneously, poor health, depression, antisocial personality disorder and lifetime sex-trading were associated with sexual trauma exposure. When these significant factors were controlled, the experience of sexual trauma predicted recent (past 4 month) high risk sexual behaviors such as higher than average sexual partners. Treatment efforts with women who have experienced a sexual trauma may be enhanced by the inclusion of assessments of physical and mental health needs as well as sexual risk awareness training.


Sexual trauma exposure HIV-risk Substance dependence 


  1. 1.
    Centers for Disease Control. HIV/AIDS in the United Sates. 2009. Accessed 29 Apr 2010.
  2. 2.
    Johnson SD, Cunningham-Williams R, Cottler LB. A tripartite of HIV-risk African American women: the intersection of drug use, violence, and depression. Drug Alcohol Depend. 2003;70(2):169–75.CrossRefPubMedGoogle Scholar
  3. 3.
    Hebert MR, Rose JS, Rosengard C, Clarke JG, Stein MD. Levels of trauma among women inmates with HIV risk and alcohol use disorders: behavioral and emotional impacts. J Trauma Dissociation. 2007;8(2):27–46.CrossRefPubMedGoogle Scholar
  4. 4.
    Dévieux JG, Malow R, Lerner BG, Dyer JG. Triple jeopardy for HIV: substance using severely mentally ill adults. J Prev Interv Community. 2007;33:5–18.CrossRefPubMedGoogle Scholar
  5. 5.
    Johnson SD, Striley C, Cottler L. The association of substance use disorders with trauma exposure and PTSD among African American drug users. Addict Behav. 2006;31(11):2063–73.CrossRefPubMedGoogle Scholar
  6. 6.
    Cottler LB, Compton WM, Mager D, Spitznagel EL, Janca A. Posttraumatic stress disorder among substance users from the general population. Am J Psychiatry. 1992;149:664–70.PubMedGoogle Scholar
  7. 7.
    Cottler LB, Nishith P, Compton WM. Gender differences in risk factors for trauma exposure and post-traumatic stress disorder among inner city drug abusers in and out of treatment. Compr Psychiatry. 2001;42(2):111–7.CrossRefPubMedGoogle Scholar
  8. 8.
    El-Bassel N, Gilbert L, Wu E, Go H, Hill J. Relationship between drug abuse and intimate partner violence: a longitudinal study among women receiving methadone. Am J Public Health. 2005;95(3):465–70.CrossRefPubMedGoogle Scholar
  9. 9.
    Chilcoat HD, Breslau N. Posttraumatic stress disorder and drug disorders: testing causal pathways. Arch Gen Psychiatry. 1998;55(10):913–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Breslau N, Davis G, Schultz LR. Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drugs in persons who have experienced trauma. Arch Gen Psychiatry. 2003;60(3):289–94.CrossRefPubMedGoogle Scholar
  11. 11.
    Cole J, Logan TK, Shannon L. Risky sexual behavior among women with protective orders against violent male partners. AIDS Behav. 2007;11:103–12.CrossRefPubMedGoogle Scholar
  12. 12.
    Golder S, Logan TK. Correlates and predictors of women’s sex trading over time among a sample of out-of-treatment drug abusers. AIDS Behav. 2007;11:628–40.CrossRefPubMedGoogle Scholar
  13. 13.
    Booth RE, Watters JK, Chitwood DD. HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack. Am J Public Health. 1993;83:1144–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Dinwiddie SH, Cottler L, Compton W, Ben Abdallah A. Psychopathology and HIV risk behaviors among injection drug users in and out of treatment. Drug Alcohol Depend. 1996;43:1–11.CrossRefPubMedGoogle Scholar
  15. 15.
    King VL, Kidorf MS, Stoller KB, Brooner RK. Influence of psychiatric comorbidity on HIV risk behaviors; changes during drug abuse treatment. J Addict Disord. 2000;19:65–83.CrossRefGoogle Scholar
  16. 16.
    Stein MD, Solomon DA, Herman DS, Anderson BJ, Miller IW. Depression severity and drug injection HIV risk behaviors. Am J Psychiatry. 2004;160:1659–62.CrossRefGoogle Scholar
  17. 17.
    Disney E, Kidorf M, Kolodner K, King V, Pierce J, Beilenson P, Brooner RK. Psychiatric comorbidity is associated with drug use and HIV risk in syringe exchange participants. J Nerv Ment Dis. 2006;194(8):577–83.CrossRefPubMedGoogle Scholar
  18. 18.
    Erbelding EJ, Hutton HE, Zenilman JM, Hunt WP, Lyketsos CG. The prevalence of psychiatric disorders in sexually transmitted disease clinic patients and their association with sexually transmitted disease risk. Sex Transm Dis. 2004;31(1):8–12.CrossRefPubMedGoogle Scholar
  19. 19.
    Bensley LS, Van Eenwyk J, Simmons KW. Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. Am J Prev Med. 2000;18:151–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Parillo KM, Freeman RC, Collier K, Young P. Association between early sexual abuse and adult HIV-risky sexual behaviors among community-recruited women. Child Abuse Negl. 2001;25:335–46.CrossRefPubMedGoogle Scholar
  21. 21.
    Wyatt GE, Myers HF, Williams JK, et al. Does a history of trauma contribute to HIV-risk for women of color? Implications for prevention and policy. Am J Public Health. 2002;92(4):660–5.CrossRefPubMedGoogle Scholar
  22. 22.
    Myers HF, Wyatt GE, Loeb TB, et al. Severity of child sexual abuse, post-traumatic stress and risky sexual behaviors among HIV-positive women. AIDS Behav. 2006;10(2):191–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Vaddiparti K, Bogetto J, Callahan C, Ben Abdallah A, Spitznagel E, Cottler L. The effects of childhood trauma on sex trading in substance using women. Arch Sex Behav. 2006;35:451–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Senn TE, Carey MP, Vanable PA. Childhood and adolescent sexual abuse and subsequent sexual risk behavior: evidence from controlled studies, methodological critique, and suggestions for research. Clin Psychol Rev. 2008;28(5):711–35.CrossRefPubMedGoogle Scholar
  25. 25.
    Pearce ME, Christian WM, Patterson K, et al. The Cedar Project: historical trauma, sexual abuse and HIV risk among young aboriginal people who use injection and non-injection drugs in two Canadian cities. Soc Sci Med. 2008;66:2185–94.CrossRefPubMedGoogle Scholar
  26. 26.
    Cavanaugh CE, Hansen NB, Sullivan TP. HIV sexual risk behavior among low-income women experiencing intimate partner violence: the role of posttraumatic stress disorder. AIDS Behav. 2010;14:318–27.CrossRefPubMedGoogle Scholar
  27. 27.
    Robins LN, Cottler LB, Bucholz KK, Compton WM. Diagnostic interview schedule, version 4.0 (DIS 4.0). St. Louis, MO: Washington University; 1996.Google Scholar
  28. 28.
    Horton J, Compton WM, Cottler LB. Assessing psychiatric disorders among drug users: reliability of the revised DIS-IV. In: Harris L, editor. NIDA research monograph-problems of drug dependence. Washington, DC: NIH Publication No. 99-4395; 1998.Google Scholar
  29. 29.
    Cottler LB, Robins LN, Helzer JE. The reliability of the Composite International Diagnostic Interview Substance Abuse Module (CIDI-SAM)—a comprehensive substance abuse interview. Br J Addict. 1989;84:801–14.CrossRefPubMedGoogle Scholar
  30. 30.
    Compton WM, Cottler LB, Dorsey KB, et al. Comparing assessments of DSM-IV substance dependence disorders using CIDI-SAM and SCAN. Drug Alcohol Depend. 1996;41(3):179–87.CrossRefPubMedGoogle Scholar
  31. 31.
    Decker MR, Seage GR, Hemenway D, et al. Intimate partner violence functions as both a risk marker and risk factor for women’s HIV infection: findings from Indian husband-wife dyads. J Acquir Immune Defic Syndr. 2009;51(5):593–600.CrossRefPubMedGoogle Scholar
  32. 32.
    El-Bassel N, Caldeira NA, Ruglass LM, Gilbert L. Addressing the unique needs of African American women in HIV prevention. Am J Public Health. 2009;99(6):996–1001.CrossRefPubMedGoogle Scholar
  33. 33.
    Kelley LP, Weathers FW, McDevitt-Murphy ME, Eakin DE, Flood AM. A comparison of PTSD symptom patterns in three types of civilian trauma. J Trauma Stress. 2009;22(3):227–35.CrossRefPubMedGoogle Scholar
  34. 34.
    Teicher MH, Samson JA, Polcari A, Andersen SL. Length of time between onset of childhood sexual abuse and emergence of depression in a young adult sample: a retrospective clinical report. J Clin Psychiatry. 2009;70(5):684–91.CrossRefPubMedGoogle Scholar
  35. 35.
    Lang AJ, Rodgers CS, Laffaye C, Satz LE, Dresselhaus TR, Stein MB. Sexual trauma, posttraumatic stress disorder, and health behavior. Behav Med. 2003;28(4):150–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Stockman JK, Campbell JC, Celentano DD. Sexual violence and HIV risk behaviors among a representative sample of heterosexual American women: the importance of sexual coercion. J Acquir Immune Defic Syndr. 2010;53(1):136–43.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sharon D. Johnson
    • 1
  • Linda B. Cottler
    • 2
  • Arbi Ben Abdallah
    • 2
  • Catina Callahan O’Leary
    • 2
  1. 1.School of Social WorkUniversity of Missouri—St. LouisSt. LouisUSA
  2. 2.Department of PsychiatryWashington University School of MedicineSt. LouisUSA

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