title: A Case Study of Sexual Abuse and Psychological Correlates among an HIV-Serodiscordant Couple.
abstract: Childhood sexual abuse (CSA), adult sexual abuse (ASA) and intimate partner violence (IVP) are documented risk factors for HIV infection and are often implicated in the presentation of mental health disorders in both males and females, including those who are vulnerable to HIV-infection (African-Americans; trauma survivors). As such, these issues may contribute to health-related challenges among couples, particularly if the individuals are impacted by histories of trauma and HIV. Presented here is a case study of one couple with self-reported histories of CSA and clinically significant symptoms of posttraumatic stress disorder (PTSD) and depression. This couple was selected from a larger National Institute of Mental Health (NIMH)-funded study of 535 African-American HIV-serodiscordant heterosexual couples (see El Bassel, 2010). The study couple completed 8 sessions of an HIV sexual risk reduction intervention program to increase condom use. Although the couple reported an initial increase in condom use at the immediate post intervention assessment, condom use decreased to baseline assessment levels at the 12-month post intervention assessment. The decrease in HIV-transmission protective behaviors over time (i.e., condom use), in part, may be attributable to the clinically significant psychological distress symptoms of PTSD and depression that were maintained from baseline, throughout the trial, and at follow-up assessments. We propose that the success of sexual risk reduction interventions may be attenuated and compromised over time by the presence of sexual trauma histories and the residual mental health issues. We discuss clinical implications for health care professionals in their work with couples, especially those from racially diverse groups.
authors.affiliation: Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
authors.forename: Gail E
authors.initials: GE
authors.lastname: Wyatt
authors.forename: Tamra B
authors.initials: TB
authors.lastname: Loeb
authors.forename: John K
authors.initials: JK
authors.lastname: Williams
authors.forename: Teri D
authors.initials: TD
authors.lastname: Davis
authors.forename: Muyu
authors.initials: M
authors.lastname: Zhang
keywords: HIV; couples therapy; sexual trauma
references.citation: J Urban Health. 2005 Mar;82(1 Suppl 1):i89-99
references.pmid: 15738316
references.citation: J Child Sex Abus. 2010 Jan;19(1):43-61
references.pmid: 20390778
references.citation: Am J Public Health. 2002 Apr;92(4):660-5
references.pmid: 11919068
references.citation: J Psychiatr Ment Health Nurs. 2010 Feb;17(1):9-18
references.pmid: 20100302
references.citation: Child Abuse Negl. 2011 Nov;35(11):946-55
references.pmid: 22078081
references.citation: Psychol Bull. 2000 Sep;126(5):651-680
references.pmid: 10989615
references.citation: J Consult Clin Psychol. 2010 Apr;78(2):249-59
references.pmid: 20350035
references.citation: Annu Rev Sex Res. 2002;13:307-45
references.pmid: 12836735
references.citation: J Consult Clin Psychol. 2008 Apr;76(2):194-207
references.pmid: 18377117
references.citation: J Trauma Dissociation. 2010;11(2):152-73
references.pmid: 20373204
references.citation: Arch Sex Behav. 2009 Feb;38(1):121-34
references.pmid: 17999171
references.citation: Am Fam Physician. 2006 Jan 15;73(2):271-80
references.pmid: 16445273
references.citation: Psychol Bull. 2006 Nov;132(6):959-92
references.pmid: 17073529
references.citation: Curr HIV/AIDS Rep. 2008 Nov;5(4):163-71
references.pmid: 18838056
references.citation: J Acquir Immune Defic Syndr. 2008 Sep 1;49 Suppl 1:S42-51
references.pmid: 18724190
references.citation: Clin Psychol Rev. 2008 Jun;28(5):711-35
references.pmid: 18045760
references.citation: J Consult Clin Psychol. 2003 Dec;71(6):987-96
references.pmid: 14622074
references.citation: J Adolesc. 1998 Feb;21(1):99-107
references.pmid: 9503078
references.citation: Child Abuse Negl. 2003 May;27(5):525-40
references.pmid: 12718961
references.citation: Violence Vict. 2010;25(4):518-35
references.pmid: 20712149
references.citation: Nurs Res. 1982 Sep-Oct;31(5):278-83
references.pmid: 6922469
references.citation: J Consult Clin Psychol. 2008 Apr;76(2):272-81
references.pmid: 18377123
references.citation: J Child Sex Abus. 2009 Nov;18(6):655-72
references.pmid: 20183424
references.citation: Child Abuse Negl. 2005 Jul;29(7):767-782
references.pmid: 16051351
references.citation: Child Maltreat. 2000 Feb;5(1):28-38
references.pmid: 11232060
references.citation: J Child Sex Abus. 2009 Jul-Aug;18(4):367-85
references.pmid: 19842535
references.citation: Clin Psychol Rev. 2001 Jun;21(4):553-76
references.pmid: 11413867
references.citation: J Interpers Violence. 2003 Dec;18(12):1452-71
references.pmid: 14678616
references.citation: AIDS Educ Prev. 1996 Feb;8(1):44-57
references.pmid: 8703640
references.citation: J Consult Clin Psychol. 2009 Aug;77(4):680-92
references.pmid: 19634961
references.citation: J Sex Med. 2010 May;7(5):1901-10
references.pmid: 19678881
references.citation: AIDS. 2005 Dec 2;19(18):2057-67
references.pmid: 16284454
references.citation: Child Abuse Negl. 2000 Mar;24(3):391-409
references.pmid: 10739083
references.citation: J Sex Marital Ther. 2006 May-Jun;32(3):215-34
references.pmid: 16809250
references.citation: Am J Public Health. 2009 May;99(5):847-54
references.pmid: 18703446
references.citation: Am J Public Health. 2012 Jan;102(1):156-62
references.pmid: 22095358
references.citation: Psychol Med. 1983 Aug;13(3):595-605
references.pmid: 6622612
references.citation: Psychosom Med. 2008 Feb;70(2):186-91
references.pmid: 18256344
references.citation: Arch Intern Med. 2010 Sep 27;170(17):1594-601
references.pmid: 20625011
references.citation: J Behav Med. 2008 Oct;31(5):445-51
references.pmid: 18726151
references.citation: Depress Anxiety. 2012 Feb;29(2):123-30
references.pmid: 22065593
references.citation: J Consult Clin Psychol. 1999 Jun;67(3):300-7
references.pmid: 10369050
references.citation: J Nurse Midwifery. 1995 Jan-Feb;40(1):26-30
references.pmid: 7869146
references.citation: J Interpers Violence. 2014 Feb 5;29(13):2439-2457
references.pmid: 24505086
references.citation: J Trauma Stress. 2009 Dec;22(6):566-74
references.pmid: 19937646
references.citation: J Trauma Stress. 2008 Dec;21(6):540-7
references.pmid: 19107722