Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood
Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood
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DOI：
10.1007/s10508-007-9238-4
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发表时间：
2009-02-01
影响因子：
3.8
通讯作者：
Fox, Ashley M.
中科院分区：
文献类型：
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作者：
Sikkema, Kathleen J.;Hansen, Nathan B.;Fox, Ashley M.
儿童期性虐待（CSA）与HIV性危险行为有关。虽然已经确定了许多与HIV阳性者性风险相关的心理社会因素，但预测有CSA病史的HIV阳性成年人持续风险的研究有限。这项横断面研究确定了256名有CSA病史的HIV阳性成年人（女性和男性）的种族多样性样本中预测性传播风险行为的变量。参与者被评估创伤症状，与艾滋病毒和性创伤有关的羞耻，物质使用，应对方式和性风险行为。进行逻辑回归分析，以确定在过去4个月内无保护性行为的预测变量。无保护的性行为与物质使用和创伤相关的行为困难显着相关的女性和男性，以及男性的精神应对。与艾滋病毒呈阴性或血清状况未知的伴侣发生无保护的性行为与更大的创伤相关行为困难、更多的艾滋病毒相关羞耻感和更少的积极应对策略显着相关。因此，创伤症状，羞耻，应对方式，和物质使用显着相关的性风险行为与艾滋病毒阳性的成年人CSA的历史，预测模型不同的性别和合作伙伴的血清状态。对有艾滋病和CSA病史的人进行艾滋病预防干预，应解决与创伤有关的行为困难，提高应对技能，以减少性传播风险行为。
Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.