Limited material resources, exposure to violence, and high-risk sexual behaviors were the best predictors of HIV risk.

Child sexual abuse (CSA) is associated with HIV risk behaviors [Bensley, L., Van Eenwyk, J., and Simmons, K. W., 2003.] and more prevalent among women living with HIV than in the general population [Koenig, L. J., and Clark, H., 2004]. This randomized Phase~I clinical trial tested the impact of a culturally congruent psychoeducational intervention designed to reduce sexual risks and increase HIV medication adherence for HIV-positive women with CSA histories. An ethnically diverse sample of 147 women were randomized to two conditions: an 11-session Enhanced Sexual Health Intervention (ESHI) or an attention control. Results based on "intent to treat'' analyses of pre-post changes are reported here. Additional analyses explored whether the observed effects might depend on "intervention dose,'' i.e., number of sessions attended. Women in the ESHI condition reported greater sexual risk reduction than women in the control condition. Although there were no differences between women in the ESHI and control groups on medication adherence, women in the ESHI condition who attended 8 or more sessions reported greater medication adherence at posttest than control women. The findings provide initial support for this culturally and gender-congruent psychoeducational intervention for HIV-positive women with CSA, and highlight the importance of addressing the effects of CSA on sexual risk reduction and medication adherence in preventive interventions for women.

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Objective-Adult posttraumatic stress symptoms (PSS) and a biomarker index of current health risk in childhood sexual abuse (CSA) survivors was investigated in relation to CSA severity, disclosure and other peri-and post-trauma factors.Methods-A community sample of 94 African American and Latina women CSA survivors was assessed.Results-Severe CSA predicted PSS overall, avoidance/numbing symptoms and greater biomarker risk, and was not mediated by post-trauma variables. Moderate CSA severity was mediated by post-trauma disclosure, predicted re-experiencing symptoms but was unrelated to biomarker risk. No overall ethnic differences were found.Conclusions-Results suggest targets for interventions to improve the well-being of minority women CSA survivors.