Victimization and Sexual Risk Behavior in Young, HIV Positive Women: Exploration of Mediators

Abstract

In this study we explore associations between child and adult victimization and sexual risk behavior in 118 young, HIV positive women. Prior research has demonstrated associations between victimization and engagement in sexual risk behavior. Victimization sequelae can include disrupted assertiveness and communication, as well as increased association with risky partners, both of which are also linked with engagement in sexual risk behavior. Thus, we propose a model wherein victimization is linked to sexual risk behavior through two mediating pathways, sexual communication and affiliation with risky partners. We also examine the moderating effects of the presence of an anxiety or depressive disorder on the path from child to adult victimization. Results suggested that adult victimization was associated with unprotected sex with a main partner; however, this association was mediated by less sexual communication and having a risky partner. Trends toward significance were found for depression and anxiety as a moderator of the relationship between child and adult victimization. Child victimization did not have direct effects on unprotected sex. Implications for secondary prevention of HIV and healthy intimate relationships are discussed.

The Reproductive Health Behaviors of HIV-Infected Young Women in the United States: A Literature Review

“…28 In two other studies, the percent of BHIV young women who thought their male partners were also having other partners ranged from 22% to 36%. 19,21 These two studies also found sexually active HIV-infected young women to have a mean of 1.9 and 1.8 partners in the previous three months. 21,28 674 CARTER ET AL.…”

“…Eight studies (Table 1) came from research conducted under the auspices of the ATN 8,9,[19][20][21][22][23][24] and four came from ATN's precursor, the REACH study, [25][26][27][28] an NIH-funded research network that recruited BHIV and HIV-uninfected at-risk youth ages 12-18 years, from 16 clinical care sites across the US between 1996 and 1999. Other studies came from intervention research samples (e.g., Adolescent Impact Study 29,30 ) and other research cohorts [e.g., Women's Interagency HIV Study (WIHS), 31 LE-GACY 32 ].…”

“…8,[33][34][35] Nine studies had HIV-uninfected counterparts as part of the analytic sample to serve as a comparison group. 14,25,28,31,[36][37][38][39][40] Ten studies focused on samples of only young women, 8,9,14,19,25,28,31,33,39,41 while the remainder had samples that included both young men and women. Eight studies included only BHIV.…”

“…Eight studies included only BHIV. 8,9,19,21,[25][26][27][28] Because of a recently published review article on PHIV adolescents, 7 we only included eight articles focused on just PHIV. 33,[35][36][37][38][40][41][42] Those were published since the review or were outside the scope of the review; one was included in the review, but is highlighted here from a different perspective.…”

“…In a survey of 118 BHIV young women, 89% reported childhood victimization (physical or sexual abuse, neglect, or witnessing violence as a child) and 50% reported experiencing or witnessing violence as an adult. 19 Older studies also documented high prevalence of childhood sexual abuse among young women with HIV. 44,45 In-depth qualitative interviews with 40 HIV-infected young women with a history of past sexual or physical abuse identified various ways that those experiences factored into their sexual relationships.…”