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

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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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ACKNOWLEDGMENTS

This research was funded by grant No. MH059496-0451 from the National Institute of Mental Health, Office on AIDS. The authors wish to acknowledge the contributions of Marc Pincus, Agnes Asuan-O’Brien, Julie Gustafson, and Elizabeth Robles for their assistance in the preparation of this manuscript.

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Correspondence to Hector F. Myers.

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Myers, H.F., Wyatt, G.E., Loeb, T.B. et al. Severity of Child Sexual Abuse, Post- Traumatic Stress and Risky Sexual Behaviors Among HIV-Positive Women. AIDS Behav 10, 191–199 (2006). https://doi.org/10.1007/s10461-005-9054-6

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