Exploring the Impact of Childhood Abuse on HIV Social and Attitudinal Factors Among Adults With and Without this History in Sub-Saharan Africa: Findings from NIMH Project Accept (HPTN 043).
Using data from four sites in three African countries, this community randomized study examined the association between childhood sexual and/or physical abuse (CSA and/or CPA) and HIV disclosure, HIV-related stigma, stress, and social support among adults with and without a history of abuse. A history of abuse among men was associated with higher levels of adult-reported stress and HIV-related stigma, and with significantly lower rates of HIV test result disclosure to current partners. Women with a history of CSA and/or CPA had significantly higher perceived stigma, discrimination and stress. Although childhood abuse was significantly associated with adult stress and stigmatization, participants with histories of CSA and/or CPA also reported significantly higher perceived social support compared to people without such experiences. These findings may reflect support received in response to disclosure of CSA or CPA or emotional ambivalence in relationships that have been found to be associated with child abuse. We conclude that it is critical for HIV prevention interventions to advocate for the primary prevention of child abuse, for early identification of adolescents and adults who report experiencing childhood abuse, and to address stigma and stress-related attitudinal, behavioral and relationship difficulties experiences as an aftermath of early abuse that increase their risk of HIV.
DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.|HIV/AIDS, STIs & TB (HAST) Programme, Human Sciences Research Council, Intuthuko Junction, 750 Francois Road, Cato Manor, Durban, 4001, South Africa.
Linda
L
Richter
HIV/AIDS, STIs & TB (HAST) Programme, Human Sciences Research Council, Intuthuko Junction, 750 Francois Road, Cato Manor, Durban, 4001, South Africa. tmakusha@hsrc.ac.za.
Tawanda
T
Makusha
Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic.
Arnošt
A
Komárek
UCLA Center for World Health, University of California Los Angeles, Los Angeles, CA, USA.
Joseph
J
Daniels
UCLA Center for World Health, University of California Los Angeles, Los Angeles, CA, USA.
Tom
T
Coates
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000349:Africa; D017954:Africa South of the Sahara; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D019966:Substance-Related Disorders; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult
Adult stress and social support; Child physical abuse; Child sexual abuse; HIV disclosure; HIV-related stigma