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HIV-positive Survivors of Sexual Abuse Who Receive Coping Intervention Less Likely to Engage in Unprotected Sex

Science Update

HIV-positive people who have experienced childhood sexual abuse are less likely to engage in risky sexual behavior if they receive a group intervention designed to help them cope with their traumatic history, according to an NIMH-funded study published April 1, 2008, in the Journal of Acquired Immune Deficiency Syndrome.

Previous research has found that people living with HIV are more likely than the general population to have experienced sexual abuse during childhood. Those with a history of sexual abuse are also more likely to engage in unprotected sexual behavior that can contribute to the spread of HIV and AIDS. In addition, the psychological consequences of childhood sexual abuse, such as low self-esteem, avoidance, and self-destructiveness, are associated with risky sexual behavior.

Kathleen J. Sikkema, Ph.D., of Duke University, and colleagues developed a structured, manual-based intervention designed to help participants cope not only with HIV but also with the impact and consequences of their childhood trauma. The researchers randomly assigned 247 HIV-positive men and women with a history of childhood sexual abuse to either the 15-session coping group intervention, or to a 15-session social support group. Sexual behavior was measured at the beginning of the intervention period, and at four, eight and 12 months post intervention.

Across all of the follow-up periods, the researchers found more of a decrease in the frequency of unprotected sexual activity among the coping intervention group than the support group. By 12 months post intervention, those in the coping intervention group had reduced their rate of unprotected sexual behavior by an average of 54 percent compared with the support group.

The researchers conclude that risky behavior among HIV-positive adults with abuse histories can be reduced more effectively by addressing trauma-related factors such as shame, coping difficulties and relationship issues than by just providing general social support.

Reference

Sikkema KJ, Wilson PA, Hansen NB, Kochman A, Neufeld S, Ghebremichael MS, Kershaw T. Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse . Journal of Acquired Immune Deficiency Syndrome. 2008 Apr 1; 47(4): 506-513.