History of Traumatic Events in HIV-Positive Individuals: Risk Behavior Implications in an Urban Clinic Setting

Abstract

As HIV=AIDS continues to disproportionately affect African American communities, the need for culturally appropriate, tailored interventions for this clientele is growing. Although prevention efforts often include information about individual coping and mental health, not all programs address the role of traumatic events, including community violence in relation to HIV risk. The authors implemented the Treatment Advocacy Program-Sinai with HIV-positive individuals at a large urban hospital. After controlling for demographics and other psychosocial factors, they found that a history of traumatic events-domestic, sexual, and community violence-were associated with sexual risk behavior for men and women in our sample; however, community violence 110 was overwhelming associated with sexual risk for women. Based on the prevalence of violence and the relationship with sexual risk, they discuss implications for prevention interventions in urban clinic settings.

A Review of Recent Literature on Trauma Among Individuals Living with HIV

“…Community violence, defined as lifetime experience of violent crime, had the strongest effect on sexual risk behaviors, independent of domestic violence, sexual victimization, drug use, and negative affect (e.g., depression). While men were more likely to report experiencing community violence, only women experienced an increase in sexual risk behaviors associated with community violence exposure, providing evidence of a moderating effect of gender [8]. This study expands upon the limited science associating experiences of violence in the community among individuals living with HIV and sexual risk.…”

Associations Between Lifetime Traumatic Experiences and HIV-Risk Behaviors Among Young Men Living in Informal Settlements in South Africa: A Cross-Sectional Analysis and Structural Equation Model

“…29–31 Few studies have explored among nonconflict affected populations the impact of traumatic events on men's mental health, or HIV-risk behaviors, and those that do, suggest a relationship. 32,33…”

“…[29][30][31] Few studies have explored among nonconflict affected populations the impact of traumatic events on men's mental health, or HIV-risk behaviors, and those that do, suggest a relationship. 32,33 In this article, we aim to understand the relationship between men's experiences of traumatic experiences in their life and HIV-risk behaviors. We seek to test 3 hypotheses: (1) that men who experience traumatic events have increased HIV-risk behaviors; (2) that there is a dose response between traumatic events and HIV-risk behavior; and, (3) that the pathways between trauma experienced outside the home and HIV-risk behavior are both direct, but also mediated through poorer mental health, alcohol use, and gender inequitable masculinities.…”