title: Recent trauma is associated with antiretroviral failure and HIV transmission risk behavior among HIV-positive women and female-identified transgenders.
abstract: Trauma and posttraumatic stress disorder disproportionally affect HIV-positive women. Studies increasingly demonstrate that both conditions may predict poor HIV-related health outcomes and transmission-risk behaviors. This study analyzed data from a prevention-with-positives program to understand if socio-economic, behavioral, and health-related factors are associated with antiretroviral failure and HIV transmission-risk behaviors among 113 HIV-positive biological and transgender women. An affirmative answer to a simple screening question for recent trauma was significantly associated with both outcomes. Compared to participants without recent trauma, participants reporting recent trauma had over four-times the odds of antiretroviral failure (AOR 4.3; 95% CI 1.1-16.6; p = 0.04), and over three-times the odds of reporting sex with an HIV-negative or unknown serostatus partner (AOR 3.9; 95% CI 1.3-11.9; p = 0.02) and <100% condom use with these partners (AOR 4.5; 95% CI 1.5-13.3; p = 0.007). Screening for recent trauma in HIV-positive biological and transgender women identifies patients at high risk for poor health outcomes and HIV transmission-risk behavior.
authors.affiliation: Department of Medicine, University of California, 400 Parnassus Avenue, Box 0320, San Francisco, CA, 94143, USA. Edward.Machtinger@ucsf.edu
authors.forename: E L
authors.initials: EL
authors.lastname: Machtinger
authors.forename: J E
authors.initials: JE
authors.lastname: Haberer
authors.forename: T C
authors.initials: TC
authors.lastname: Wilson
authors.forename: D S
authors.initials: DS
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002140:California; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology / Q000635:transmission*; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D055118:Medication Adherence; D008603:Mental Health; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D017211:Treatment Failure; D014754:Violence / Q000523:psychology*; D055815:Young Adult; D008297:Male
chemical_list: D044966:Anti-Retroviral Agents