A model to explain the relationship between sexual abuse and HIV risk among women

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Intimate Partner and Family Violence Sexual Assault and Victimization Studies HIV, Drug Use, Sexual Risk

Abstract

This paper presents a model developed to advance the understanding of the relationship between sexual abuse and HIV risk among women. It is proposed that the relationship is mediated by many of the long-term sequelae of sexual abuse. The process of mediation is believed to occur through various causal pathways propelled by specific underlying mechanisms that increase the likelihood of HIV risk. The following causal pathways are proposed: (1) initiation of and/or increasing reliance on drug use as a method of coping with the sexual abuse experience, (2) problems with sexual adjustment related to sex risk taking, and (3) psychopathology (e.g. depression) which increases the likelihood of an individual participating in HIV risk behaviours. These hypothesized pathways are based on the characteristics and behaviours of individuals with histories of sexual abuse and do not take into account the influence of the individual's social environment. Increasingly, evidence suggests that understanding the social context of HIV risk is crucial to the development of preventive interventions. Therefore, a final pathway is explored which suggests that specific social network characteristics (e.g. network membership type, social support, and social isolation) influence HIV risk exposure opportunities among women with sexual abuse histories.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 1995Posttraumatic Stress Disorder in the National Comorbidity Survey 2009Diagnostic and Statistical Manual of Mental Disorders 1992Shattered Assumptions: Towards a New Psychology of Trauma 1986Impact of child sexual abuse: A review of the research.1984Lifetime Prevalence of Specific Psychiatric Disorders in Three Sites 1993Impact of sexual abuse on children: A review and synthesis of recent empirical studies.1991Traumatic Events and Posttraumatic Stress Disorder in an Urban Population of Young Adults

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2007Childhood and adolescent sexual abuse and subsequent sexual risk behavior: Evidence from controlled studies, methodological critique, and suggestions for research 2001Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men’s Health Study☆2008An examination of risky sexual behavior and HIV in victims of child abuse and neglect: A 30-year follow-up.2005A meta-analysis of the relationship of child sexual abuse to HIV risk behavior among women

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