The efficacy of an integrated risk reduction intervention for HIV-positive women with child sexual abuse histories.
Child sexual abuse (CSA) is associated with HIV risk behaviors [Bensley, L., Van Eenwyk, J., and Simmons, K. W., 2003.] and more prevalent among women living with HIV than in the general population [Koenig, L. J., and Clark, H., 2004]. This randomized Phase~I clinical trial tested the impact of a culturally congruent psychoeducational intervention designed to reduce sexual risks and increase HIV medication adherence for HIV-positive women with CSA histories. An ethnically diverse sample of 147 women were randomized to two conditions: an 11-session Enhanced Sexual Health Intervention (ESHI) or an attention control. Results based on "intent to treat'' analyses of pre-post changes are reported here. Additional analyses explored whether the observed effects might depend on "intervention dose,'' i.e., number of sessions attended. Women in the ESHI condition reported greater sexual risk reduction than women in the control condition. Although there were no differences between women in the ESHI and control groups on medication adherence, women in the ESHI condition who attended 8 or more sessions reported greater medication adherence at posttest than control women. The findings provide initial support for this culturally and gender-congruent psychoeducational intervention for HIV-positive women with CSA, and highlight the importance of addressing the effects of CSA on sexual risk reduction and medication adherence in preventive interventions for women.
Wyatt
Gail E
GE
Neuropsychiatric Institute, University of California at Los Angeles, Los Angeles, California 90024-1759, USA. gwyatt@mednet.ucla.edu
Longshore
Douglas
D
Chin
Dorothy
D
Carmona
Jennifer Vargas
JV
Loeb
Tamra Burns
TB
Myers
Hector F
HF
Warda
Umme
U
Liu
Honghu
H
Rivkin
Inna
I
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015704:CD4 Antigens / Q000276:immunology; D016827:CD8 Antigens / Q000276:immunology; D002648:Child; D002650:Child Abuse, Sexual / Q000208:ethnology / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003469:Culture; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006679:HIV Seropositivity / Q000208:ethnology / Q000276:immunology / Q000628:therapy*; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000600:supply & distribution; D040242:Risk Reduction Behavior; D012944:Social Support; D014932:Women's Health Services / Q000600:supply & distribution
D019380:Anti-HIV Agents; D015704:CD4 Antigens; D016827:CD8 Antigens