title: The efficacy of an integrated risk reduction intervention for HIV-positive women with child sexual abuse histories.
abstract: 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.
authors.affiliation: Neuropsychiatric Institute, University of California at Los Angeles, Los Angeles, California 90024-1759, USA. gwyatt@mednet.ucla.edu
authors.forename: Gail E
authors.initials: GE
authors.lastname: Wyatt
authors.forename: Douglas
authors.initials: D
authors.lastname: Longshore
authors.forename: Dorothy
authors.initials: D
authors.lastname: Chin
authors.forename: Jennifer Vargas
authors.initials: JV
authors.lastname: Carmona
authors.forename: Tamra Burns
authors.initials: TB
authors.lastname: Loeb
authors.forename: Hector F
authors.initials: HF
authors.lastname: Myers
authors.forename: Umme
authors.initials: U
authors.lastname: Warda
authors.forename: Honghu
authors.initials: H
authors.lastname: Liu
authors.forename: Inna
authors.initials: I
authors.lastname: Rivkin
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents; D015704:CD4 Antigens; D016827:CD8 Antigens