Ethnicity, Serostatus, and Psychosocial Differences in Sexual Risk Behavior Among HIV-Seropositive and HIV-Seronegative Women

Abstract

Childhood sexual abuse and related life traumas, and other psychosocial variables were investigated as contributors to ethnic differences in sexual risk behaviors among women who differed in HIV-serostatus. A multiethnic sample of 457 HIV-positive and HIV-negative women residing in Los Angeles county was recruited and studied over 2 years as part of the UCLA-Charles R. Drew University Women and Family Project (WFP) study. Comprehensive interviews were administered to participants by ethnically- and linguistically matched interviewers. Data on demographic information, sexual trauma, substance abuse/dependence, psychiatric distress, and sexual history and risk behaviors were collected. The sample for these analyses consisted of 155 African American, 153 European American, and 149 Latina women, and nearly two-thirds of the sample was HIV-seropositive. HIV-positive women were significantly more likely to report more posttraumatic stress, chronic stress, negative health behaviors, drug use, and psychiatric history than HIV-negative women. European American and African American women were more likely to report a history of sexual trauma than Latina women. Finally, Poisson regression analyses revealed that history of trauma, ethnicity, drug and alcohol use, homelessness, and being HIV-positive were associated with greater likelihood of engaging in high-risk sexual behaviors, with history of trauma increasing the likelihood of engaging in high-risk behaviors by 5.1%. These findings highlight important differences among women as a function of ethnicity and HIV status, and underscore the need for special services for HIV-positive women that address the risk-enhancing effects of substance abuse/dependence, homelessness, and sexual trauma.

Age and HIV Sexual Risk among Women in Methadone Treatment

“…Background characteristics included age, race/ethnicity, highest grade completed in school, marital status, and annualized report of average monthly income from all sources in the past year. We divided the sample into three age categories: younger group (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), middle group (35)(36)(37)(38)(39)(40)(41)(42)(43)(44), and older group (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55). As Levy et al [58] note, there is no scientific consensus among HIV/AIDS researchers about the age categories of midlife and older adults.…”

“…It addresses critically important research gaps to guide gender-and age-informed HIV prevention and intervention strategies among this population. Specifically, while adjusting for potential confounders, including sociodemographic characteristics, intimate partner violence exposure [36,[44][45][46], trauma [47][48][49], depression [38,43,50], HIV status [49,[51][52][53], substance use [14,16,49] and social support [54][55][56][57], the current study examines the relationship between age and the following HIV sexual risk behaviors among a random sample of 372 women in methadone treatment: (1) inconsistent condom use with vaginal and anal sex; and (2) substance use while engaged in sexual activity.…”

Adolescent Girls’ Offending and Health-Risking Sexual Behavior: The Predictive Role of Trauma

“…1991; Dembo, Williams, & Schmeidler, 1993;Horowitz, Weine, & Jekel, 1995;Kessler et al, 1995;Ritter, Stewart, Bernet, Coe, & Brown, 2002), to engage in health-risking sexual behavior, and to be involved in violent crimes (Brener et al, 1999;Cunningham et al, 1994;Lang et al, 2003;Paxton, Myers, Hall, & Javanbakht, 2004;Springs & Friedrich, 1992;Widom & White, 1997). The link between trauma, health-risking sexual behavior, and delinquency is of particular concern in adolescent females due to the serious public health implications associated with this constellation of behaviors (i.e., the well-documented link between adolescent criminality, the selection of antisocial partners, early pregnancy, and the intergenerational transmission of antisocial behavior; Bardone, Moffitt, Caspi, Dickson, & Silva, 1996;Quinton & Rutter, 1988;Woodward & Fergusson, 1999;Zoccolillo, Meyers & Assiter, 1997;Zoccolillo, Pickles, Quinton, & Rutter, 1992).…”

Women, Trauma, and HIV: An Overview

“…Some studies use shared datasets with samples from AIDS epicenters, while other studies include samples from understudied groups. Paxton et al (2004) and Newcomb and Carmona (2004) use data from the Los Angeles County Women and Family dataset, a longitudinal study of a multi-ethnic sample of HIV-positive and negative women. ElBassel and associates utilize a New York sample.…”

“…These samples are also diverse with respect to risk categories, ranging from sex workers (Nemoto et al, 2004) to the drug-involved (El-Bassel et al, 2004) and women living in shelters (Tucker et al, 2004). Three studies use HIV-positive samples (Galvan et al, 2004;Tucker et al, 2004;Wyatt et al, 2004)-one includes HIV-negative women at risk (El-Bassel et al, 2004), and the three studies compare HIV-positive and HIV-negative women (Paxton et al, 2004;Newcomb and Carmona, 2004). Finally, one study reports the initial results of the first risk-reduction intervention for HIV-positive women with trauma histories (Wyatt et al, 2004).…”