Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse.
OBJECTIVE
To examine the effect of a 15-session coping group intervention compared with a 15-session therapeutic support group intervention among HIV-positive men and women with a history of childhood sexual abuse (CSA) on sexual transmission risk behavior.


METHODS
A randomized controlled behavioral intervention trial with 12-month follow-up.


METHODS
A diverse sample of 247 HIV-positive men and women with histories of CSA was randomized to 1 of 2 time-matched group intervention conditions. Sexual behavior was assessed at baseline; immediately after the intervention; and at 4-, 8-, and 12-month follow-up periods (5 assessments). Changes in frequency of unprotected anal and vaginal intercourse by intervention condition were examined using generalized linear mixed models for all partners, and specifically for HIV-negative or serostatus unknown partners.


RESULTS
Participants in the HIV and trauma coping intervention condition decreased their frequency of unprotected sexual intercourse more than participants in the support intervention condition for all partners (P < 0.001; d = 0.38, 0.32, and 0.38 at the 4-, 8-, and 12-month follow-up periods, respectively) and for HIV-negative and serostatus unknown partners (P < 0.001; d = 0.48, 0.39, and 0.04 at the 4-, 8-, and 12-month follow-up periods, respectively).


CONCLUSIONS
A group intervention to address coping with HIV and CSA can be effective in reducing transmission risk behavior among HIV-positive men and women with histories of sexual trauma.
Sikkema
Kathleen J
KJ
School of Nursing, Department of Psychology and Neuroscience, and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC 27710, USA. kathleen.sikkema@duke.edu
Wilson
Patrick A
PA
Hansen
Nathan B
NB
Kochman
Arlene
A
Neufeld
Sharon
S
Ghebremichael
Musie S
MS
Kershaw
Trace
T
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D000223:Adaptation, Psychological; D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D006266:Health Education / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners