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AIDS and Behavior

, Volume 20, Issue 8, pp 1609–1620 | Cite as

Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth

  • Tiara C. Willie
  • Nicole M. Overstreet
  • Courtney Peasant
  • Trace Kershaw
  • Kathleen J. Sikkema
  • Nathan B. Hansen
Original Paper

Abstract

There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.

Keywords

Childhood sexual abuse Anxiety and depression Shame Posttraumatic growth HIV 

Notes

Acknowledgments

The research was supported by Grants from the National Institute of Mental Health (R01MH062965 and T32MH020031).

References

  1. 1.
    Basu S, Chwastiak LA, Bruce RD. Clinical management of depression and anxiety in HIV-infected adults. AIDS. 2005;19(18):10.CrossRefGoogle Scholar
  2. 2.
    Chandwani S, Koenig LJ, Sill AM, Abramowitz S, Conner LC, D’Angelo L. Predictors of antiretroviral medication adherence among a diverse cohort of adolescents with HIV. J Adolesc Health. 2012;51(3):242–51.CrossRefPubMedGoogle Scholar
  3. 3.
    Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7.PubMedGoogle Scholar
  4. 4.
    Willie TC, Overstreet NM, Sullivan TP, Sikkema KJ, Hansen NB. Barriers to HIV medication adherence: examining distinct anxiety and depression symptoms among women living with hiv who experienced childhood sexual abuse. Behav Med. (in press).Google Scholar
  5. 5.
    Mugavero M, Ostermann J, Whetten K, et al. Barriers to antiretroviral adherence: the importance of depression, abuse, and other traumatic events. AIDS Patient Care STDS. 2006;20(6):418–28.CrossRefPubMedGoogle Scholar
  6. 6.
    Briere J, Runtz M. Symptomatology associated with childhood sexual victimization in a nonclinical adult sample. Child Abuse Negl. 1988;12(1):51–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Gorcey M, Santiago J, McCall-Perez F. Psychological consequences for women sexually abused in childhood. Soc Psychiatry. 1986;21(3):129–33.CrossRefPubMedGoogle Scholar
  8. 8.
    Whetten K, Reif S, Whetten R, Murphy-McMillan LK. Trauma, mental health, distrust, and stigma among HIV-positive persons: implications for effective care. Psychosom Med. 2008;70(5):531–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Henny KD, Kidder DP, Stall R, Wolitski RJ. Physical and sexual abuse among homeless and unstably housed adults living with HIV: prevalence and associated risks. AIDS Behav. 2007;11(6):842–53.CrossRefPubMedGoogle Scholar
  10. 10.
    Kalichman SC, Sikkema KJ, DiFonzo K, Luke W, Austin J. Emotional adjustment in survivors of sexual assault living with HIV/AIDS. J Trauma Stress. 2002;15(4):289–96.CrossRefPubMedGoogle Scholar
  11. 11.
    Markowitz SM, O’Cleirigh C, Hendriksen ES, Bullis JR, Stein M, Safren SA. Childhood sexual abuse and health risk behaviors in patients with HIV and a history of injection drug use. AIDS Behav. 2011;15(7):1554–60.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Finkelhor D. Long term effects of childhood sexual abuse. Child sexual abuse: new theory and research. New York: Free Press; 1984.Google Scholar
  13. 13.
    Finkelhor D. Sexually victimized children. New York: Free Press; 1979.Google Scholar
  14. 14.
    HIV surveillance report, 2011. Centers for Disease Control and Prevention, February 2013.Google Scholar
  15. 15.
    Tangney JP, Wagner P, Gramzow R. Proneness to shame, proneness to guilt, and psychopathology. J Abnorm Psychol. 1992;101(3):469.CrossRefPubMedGoogle Scholar
  16. 16.
    Semb O, Strömsten LM, Sundbom E, Fransson P, Henningsson M. Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms. Psychol Rep. 2011;109(1):3–23.CrossRefPubMedGoogle Scholar
  17. 17.
    Boudreaux E, Kilpatrick DG, Resnick HS, Best CL, Saunders BE. Criminal victimization, posttraumatic stress disorder, and comorbid psychopathology among a community sample of women. J Trauma Stress. 1998;11(4):665–78.CrossRefPubMedGoogle Scholar
  18. 18.
    Feiring C, Taska L, Lewis M. Adjustment following sexual abuse discovery: the role of shame and attributional style. Dev Psychol. 2002;38(1):79.CrossRefPubMedGoogle Scholar
  19. 19.
    Feiring C, Taska LS. The persistence of shame following sexual abuse: a longitudinal look at risk and recovery. Child Maltreat. 2005;10(4):337–49.CrossRefPubMedGoogle Scholar
  20. 20.
    Sikkema KJ, Hansen NB, Meade CS, Kochman A, Fox AM. Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood. Arch Sex Behav. 2009;38(1):121–34.CrossRefPubMedGoogle Scholar
  21. 21.
    Persons E, Kershaw T, Sikkema KJ, Hansen NB. The impact of shame on health-related quality of life among HIV-positive adults with a history of childhood sexual abuse. AIDS Patient Care STDS. 2010;24(9):571–80.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Matos M, Pinto-Gouveia J. Shame as a traumatic memory. Clin Psychol Psychother. 2010;17(4):299–312.PubMedGoogle Scholar
  23. 23.
    Neufeld SA, Sikkema KJ, Lee RS, Kochman A, Hansen NB. The development and psychometric properties of the HIV and Abuse Related Shame Inventory (HARSI). AIDS Behav. 2012;16(4):1063–74.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Feiring C, Taska L, Chen K. Trying to understand why horrible things happen: attribution, shame, and symptom development following sexual abuse. Child Maltreat. 2002;7(1):25–39.CrossRefGoogle Scholar
  25. 25.
    Gilbert P. The relationship of shame, social anxiety and depression: the role of the evaluation of social rank. Clin Psychol Psychother. 2000;7(3):174–89.CrossRefGoogle Scholar
  26. 26.
    Gilbert P, Andrews BS. Shame interpersonal behavior, psychopathology, and culture. New York: Oxford University Press; 1998.Google Scholar
  27. 27.
    Budden A. The role of shame in posttraumatic stress disorder: a proposal for a socio-emotional model for DSM-V. Soc Sci Med. 2009;69(7):1032–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Lee RS, Kochman A, Sikkema KJ. Internalized stigma among people living with HIV-AIDS. AIDS Behav. 2002;6(4):309–19.CrossRefGoogle Scholar
  29. 29.
    Tedeschi RG, Calhoun LG. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq. 2004;15(1):1–18.CrossRefGoogle Scholar
  30. 30.
    Calhoun LG, Tedeschi RG. Handbook of posttraumatic growth: research & practice. Mahwah: Lawrence Erlbaum Associates Publishers; 2006.Google Scholar
  31. 31.
    Calhoun LG, Tedeschi RG, Tedeschi RG. Facilitating posttraumatic growth: a clinician’s guide. New York: Routledge; 2014.Google Scholar
  32. 32.
    Draucker CB, Martsolf DS, Roller C, Knapik G, Ross R, Stidham AW. Healing from childhood sexual abuse: a theoretical model. J Child Sex Abus. 2011;20(4):435–66.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Wright MOD, Crawford E, Sebastian K. Positive resolution of childhood sexual abuse experiences: the role of coping, benefit-finding and meaning-making. J Fam Violence. 2007;22(7):597–608.CrossRefGoogle Scholar
  34. 34.
    McMillen C, Zuravin S, Rideout G. Perceived benefit from child sexual abuse. J Consult Clin Psychol. 1995;63(6):1037.CrossRefPubMedGoogle Scholar
  35. 35.
    Milam JE. Posttraumatic growth among HIV/AIDS patients1. J Appl Soc Psychol. 2004;34(11):2353–76.CrossRefGoogle Scholar
  36. 36.
    Mo PKH, Lau JTF, Yu X, Gu J. The role of social support on resilience, posttraumatic growth, hopelessness, and depression among children of HIV-infected parents in mainland China. AIDS Care. 2014;26(12):1526–33.CrossRefPubMedGoogle Scholar
  37. 37.
    Prati G, Pietrantoni L. Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: a meta-analysis. J Loss Trauma. 2009;14(5):364–88.CrossRefGoogle Scholar
  38. 38.
    Tarakeshwar N, Hansen NB, Kochman A, Fox A, Sikkema KJ. Resiliency among individuals with childhood sexual abuse and HIV: perspectives on addressing sexual trauma. J Trauma Stress. 2006;19(4):449–60.CrossRefPubMedGoogle Scholar
  39. 39.
    Milam J. Posttraumatic growth and HIV disease progression. J Consult Clin Psychol. 2006;74(5):817.CrossRefPubMedGoogle Scholar
  40. 40.
    Kemppainen JK, MacKain S, Reyes D. Anxiety symptoms in HIV-infected individuals. J Assoc Nurses AIDS Care. 2013;24(1):S29–39.CrossRefPubMedGoogle Scholar
  41. 41.
    Widman L, Golin CE, Grodensky CA, Suchindran C. Do safer sex self-efficacy, attitudes toward condoms, and HIV transmission risk beliefs differ among men who have sex with men, heterosexual men, and women living with HIV? AIDS Behav. 2013;17(5):1873–82.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Jennings JM, Ellen JM, Deeds BG, et al. Youth living with HIV and partner-specific risk for the secondary transmission of HIV. Sex Transm Dis. 2009;36(7):439.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Przybyla SM, Golin CE, Widman L, Grodensky CA, Earp JA, Suchindran C. Serostatus disclosure to sexual partners among people living with HIV: examining the roles of partner characteristics and stigma. AIDS Care. 2013;25(5):566–72.CrossRefPubMedGoogle Scholar
  44. 44.
    Golin C, Marks G, Wright J, et al. Psychosocial characteristics and sexual behaviors of people in care for HIV infection: an examination of men who have sex with men, heterosexual men and women. AIDS Behav. 2009;13(6):1129–42.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Courtenay-Quirk C, Zhang J, Wolitski RJ. Intentional abstinence among homeless and unstably housed persons living with HIV/AIDS. AIDS Behav. 2009;13(6):1119–28.CrossRefPubMedGoogle Scholar
  46. 46.
    Rosa-Cunha I, Cardenas GA, Dickinson G, Metsch LR. Addressing anal health in the HIV primary care setting: a disappointing reality. AIDS Patient Care STDs. 2010;24(9):533–8.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Gaisa M, Sigel K, Hand J, Goldstone S. High rates of anal dysplasia in HIV-infected men who have sex with men, women, and heterosexual men. AIDS. 2014;28(2):215–22.CrossRefPubMedGoogle Scholar
  48. 48.
    Fields SD, Malebranche D, Feist-Price S. Childhood sexual abuse in black men who have sex with men: results from three qualitative studies. Cultur Divers Ethnic Minor Psychol. 2008;14(4):385–90.CrossRefPubMedGoogle Scholar
  49. 49.
    Bartholow BN, Doll LS, Joy D, et al. Emotional, behavioral, and HIV risks associated with sexual abuse among adult homosexual and bisexual men. Child Abuse Negl. 1994;18(9):745–61.CrossRefGoogle Scholar
  50. 50.
    Carballo-Diéguez A, Dolezal C. Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. Child Abuse Negl. 1995;19(5):595–605.CrossRefPubMedGoogle Scholar
  51. 51.
    Paul JP, Catania J, Pollack L, Stall R. Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: the Urban Men’s Health Study. Child Abuse Negl. 2001;25(4):557–84.CrossRefPubMedGoogle Scholar
  52. 52.
    Sikkema KJ, Hansen NB, Kochman A, et al. Outcomes from a group intervention for coping with HIV/AIDS and childhood sexual abuse: reductions in traumatic stress. AIDS Behav. 2007;11(1):49–60.CrossRefPubMedGoogle Scholar
  53. 53.
    Sikkema KJ, Wilson PA, Hansen NB, et al. Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse. J Acquir Immune Defic Syndr. 2008;47(4):506–13.CrossRefPubMedGoogle Scholar
  54. 54.
    Sikkema KJ, Ranby KW, Meade CS, Hansen NB, Wilson PA, Kochman A. Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse. J Consult Clin Psychol. 2013;81(2):274.CrossRefPubMedGoogle Scholar
  55. 55.
    Kaplan ML, Erensaft M, Sanderson WC, Wetzler S, Foote B, Asnis GM. Dissociative symptomatology and aggressive behavior. Compr Psychiatry. 1998;39(5):271–6.CrossRefPubMedGoogle Scholar
  56. 56.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561.CrossRefPubMedGoogle Scholar
  57. 57.
    Fethers K, Marks C, Mindel A, Estcourt CS. Sexually transmitted infections and risk behaviours in women who have sex with women. Sex Transm Infect. 2000;76(5):345–9.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Mayer KH, Bradford JB, Makadon HJ, Stall R, Goldhammer H, Landers S. Sexual and gender minority health: what we know and what needs to be done. Am J Public Health. 2008;98(6):989–95.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Beck AT, Steer RA. Manual for the Beck anxiety inventory. San Antonio: Psychological Corporation; 1990.Google Scholar
  60. 60.
    Radloff LS. The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.CrossRefGoogle Scholar
  61. 61.
    Scheier MF, Carver CS. Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol. 1985;4(3):219.CrossRefPubMedGoogle Scholar
  62. 62.
    Folkman S, Lazarus RS. Manual for the ways of coping questionnaire. Palo Alto: Consulting Psychologists Press; 1988.Google Scholar
  63. 63.
    O’Brien K, Wortman CB, Kessler RC, Joseph JG. Social relationships of men at risk for AIDS. Soc Sci Med. 1993;36(9):1161–7.CrossRefPubMedGoogle Scholar
  64. 64.
    Statistics IS (2012) IBM SPSS Statistics 21.0 for Windows. Chicago: IBMGoogle Scholar
  65. 65.
    Kline RB. Principles and practice of structural equation modeling. New York: Guilford; 2005. p. 2005.Google Scholar
  66. 66.
    Hoyle R, Panter AT. Writing about structural equation models. In: Hoyle RH, editor. Structural equation modeling: concepts, issues, and applications. Thousand Oaks: Sage Publications; 1995. p. 158–76.Google Scholar
  67. 67.
    Bollen KA. Structural equation models. New York: Wiley Online Library; 1998.Google Scholar
  68. 68.
    Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1–55.CrossRefGoogle Scholar
  69. 69.
    Muthén LK, Muthén BO. Mplus: statistical analysis with latent variables; user’s guide;[Version 3]: Muthén & Muthén; 2005.Google Scholar
  70. 70.
    Muthén LK, Muthén BO. 1998–2010 Mplus user‘s guide. Muthén and Muthén; 2010.Google Scholar
  71. 71.
    Vishnevsky T, Cann A, Calhoun LG, Tedeschi RG, Demakis GJ. Gender differences in self-reported posttraumatic growth: a meta-analysis. Psychol Women Q. 2010;34(1):110–20.CrossRefGoogle Scholar
  72. 72.
    Mosack KE, Weinhardt LS, Kelly JA, et al. Influence of coping, social support, and depression on subjective health status among HIV-positive adults with different sexual identities. Behav Med. 2009;34(4):133–44.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    MacMillan HL, Fleming JE, Streiner DL, et al. Childhood abuse and lifetime psychopathology in a community sample. Am J Psychiatry. 2001;158(11):1878–83.CrossRefPubMedGoogle Scholar
  74. 74.
    Rosario M. Implications of childhood experiences for the health and adaptation of lesbian, gay, and bisexual individuals: sensitivity to developmental process in future research. Psychol Sex Orientat Gend Divers. 2015;2(3):214–24.CrossRefPubMedGoogle Scholar
  75. 75.
    Bowlby J. Attachment and loss: attachment, vol. 1. New York: Basic Books; 1969.Google Scholar
  76. 76.
    Feiring C, Taska L, Lewis M. A process model for understanding adaptation to sexual abuse: the role of shame in defining stigmatization. Child Abuse Negl. 1996;20(8):767–82.CrossRefPubMedGoogle Scholar
  77. 77.
    Lisak D. The psychological impact of sexual abuse: content analysis of interviews with male survivors. J Trauma Stress. 1994;7(4):525–48.CrossRefPubMedGoogle Scholar
  78. 78.
    Feiring C, Taska L, Lewis M. Age and gender differences in children’s and adolescents’ adaptation to sexual abuse. Child Abuse Negl. 1999;23(2):115–28.CrossRefPubMedGoogle Scholar
  79. 79.
    Anderson CL. Males as sexual assault victims: multiple levels of trauma. J Homosex. 1982;7(2–3):145–62.CrossRefGoogle Scholar
  80. 80.
    Relf MV. Childhood sexual abuse in men who have sex with men: the current state of the science. J Assoc Nurses AIDS Care. 2001;12(5):20–9.CrossRefPubMedGoogle Scholar
  81. 81.
    Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.CrossRefPubMedGoogle Scholar
  82. 82.
    Sears SR, Stanton AL, Danoff-Burg S. The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychol. 2003;22(5):487.CrossRefPubMedGoogle Scholar
  83. 83.
    Thornton AA, Perez MA. Posttraumatic growth in prostate cancer survivors and their partners. Psychooncology. 2006;15(4):285–96.CrossRefPubMedGoogle Scholar
  84. 84.
    Park CL, Fenster JR. Stress-related growth: predictors of occurrence and correlates with psychological adjustment. J Soc Clin Psychol. 2004;23(2):195–215.CrossRefGoogle Scholar
  85. 85.
    Schroevers MJ, Teo I. The report of posttraumatic growth in Malaysian cancer patients: relationships with psychological distress and coping strategies. Psychooncology. 2008;17(12):1239–46.CrossRefPubMedGoogle Scholar
  86. 86.
    Williams JK, Glover DA, Wyatt GE, Kisler K, Liu H, Zhang M. A sexual risk and stress reduction intervention designed for HIV-positive bisexual African American men with childhood sexual abuse histories. Am J Public Health. 2013;103(8):1476–84.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Tiara C. Willie
    • 1
    • 2
  • Nicole M. Overstreet
    • 3
  • Courtney Peasant
    • 1
  • Trace Kershaw
    • 1
    • 2
  • Kathleen J. Sikkema
    • 4
  • Nathan B. Hansen
    • 5
  1. 1.Center for Interdisciplinary Research on AIDSYale UniversityNew HavenUSA
  2. 2.Division of Social and Behavioral SciencesYale School of Public HealthNew HavenUSA
  3. 3.Department of Social PsychologyClark UniversityWorcesterUSA
  4. 4.Department of Psychology and Neuroscience, and Duke Global InstituteDuke UniversityDurhamUSA
  5. 5.Department of Health Promotion and BehaviorUniversity of GeorgiaAthensUSA

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