Elsevier

Child Abuse & Neglect

Volume 17, Issue 2, March–April 1993, Pages 291-298
Child Abuse & Neglect

HIV vulnerability and the adult survivor of childhood sexual abuse

https://doi.org/10.1016/0145-2134(93)90048-AGet rights and content

Abstract

The purpose of this article is to sensitize clinicians working in the field of childhood physical/sexual abuse to the connection between untreated childhood traumatization and HIV high-risk behaviors. The characteristic abuse symptoms of chronic depression, sexual compulsivity, revictimization, and substance abuse are identified as barriers to HIV education and intervention for survivors. An overview of the existing HIV/child abuse connection research, an illustrative case history and a discussion regarding the clinical implications of these connections are offered.

Résumé

Le but de cet de article est sensibilser les cliniciens traivaillant dans le domaine de la maltraitance physique et/ou sexuelle au lien entre les traumatismes non traités pendant l'enfance et les comportements à haut risque de contamination par le virus HIV. Les symptômes caractéristiques de la maltraitance tels que la dépression chronique, la compulsivité sexuelle, la revictimisation et la toxicomanie sont identifiées comme des barrières à l'éducation à la prévention de la contamination HIV et aux interventions pour les survivants. Un revue de la recherche concernant les liens entre la maltraitance et la contamination par le virus du SIDA, une histoire de cas illustrative et une discussion des implications cliniques de ces liens sont rapportées.

Resumen

El objectivo de este artículo es sensibilizar a los clínicos que trabajan en el campo del abuso físico/sexual contra los niños sobre la relación entre la traumatizacion no tratada en la infancia y las conductas de alto riesgo de HIV. Los síntomas característicos de abuso como depresión crónica, compulsividad sexual, revictimización y abuso de sustancia son identificadas como barreras para la educación sobre HIV y la intervención para los sobrevivientes. Se ofrecen una revisión de la investigación existente sobre la relación entre HIV/abuso a los niños, un caso ilustrativo y una discusión sobre las implicaciones clínicas entre estas relaciones.

References (30)

  • E. Carmen et al.

    A psychosocial model of the victim-to-patient process

    Psychiatric Clinics of North America

    (1989)
  • K. Achte

    Types of indirect self-destruction

    Psychiatria Fennica

    (1983)
  • C.T. Allers et al.

    Connections between childhood abuse and HIV infection

    Journal of Counseling and Development

    (1991)
  • C.T. Allers et al.

    Unresolved childhood sexual abuse: Are older adults impacted?

    Journal of Counseling and Development

    (1992)
  • C.T. Allers et al.

    AIDS counseling: A psychosocial model

    Journal of Mental Health Counseling

    (1988)
  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders

    (1987)
  • C. Bagley et al.

    Disrupted childhood and vulnerability to sexual assault: Long-term sequels with implications for counseling

  • A.T. Beck et al.

    Beck Depression Inventory Manual

    (1987)
  • K.J. Benjack et al.

    Connections between childhood abuse and HIV infection: What social workers need to know

  • E.M. Bernstein et al.

    Development, reliability, and validity of a dissociation scale

    Journal of Nervous and Mental Disease

    (1986)
  • J. Briere

    The effects of childhood sexual abuse on later psychological functioning: Defining a “post-sexual-abuse syndrome”

  • A. Browne et al.

    Impact of child sexual abuse: A review of the research

    Psychological Bulletin

    (1986)
  • P.J. Carnes

    Contrary to love: Helping the sexual addict

    (1989)
  • C. Courtois

    The incest experience and its aftermath

    Victimology: An International Journal

    (1979)
  • C. Courtois

    Healing the incest wound: Adult survivors in therapy

    (1988)
  • Cited by (77)

    • Trauma and Cultural Safety: Providing Quality Care to HIV-Infected Women of Aboriginal Descent

      2014, Journal of the Association of Nurses in AIDS Care
      Citation Excerpt :

      Depression among survivors of sexual abuse is common. Characteristics include poor self-esteem, helplessness, hopelessness, and suicidal wishes as a way out of the suffering (Allers et al., 1993). Marla knew that she should take her ART as prescribed, at least 95% of the time (Chen, Hoy, & Lewin, 2007), but she sometimes felt that not taking her medications would cause her to die and she saw that as a way out of her suffering.

    • HIV-infected men who have sex with men and histories of childhood sexual abuse: Implications for health and prevention

      2013, Journal of the Association of Nurses in AIDS Care
      Citation Excerpt :

      In addition to associations between CSA and chronic health conditions, experiencing sexual abuse in childhood is also connected with a continuum of risky sexual behavior later in life. Several studies have found associations between men's CSA exposure and unprotected sex, receiving compensation for sex, and sex with multiple partners, thereby putting them at risk of contracting HIV and also putting their partners at risk (Allers et al., 1993; Bartholow et al., 1994; O'Leary et al., 2003; Zierler et al., 1991). When controlling for variables such as study site, age at enrollment, education, and race, the EXPLORE study of HIV-uninfected men (N = 4,295) from six cities across the United States found that there was a significant association between a history of CSA and unprotected anal sex (Mimiaga et al., 2009).

    • Transactional sex as a form of child sexual exploitation and abuse in Rwanda: Implications for child security and protection

      2012, Child Abuse and Neglect
      Citation Excerpt :

      The African Charter on the Rights and Welfare of the Child (Article 27) emphasizes states’ duties to “protect the child from all forms of sexual exploitation and sexual abuse,” including taking precautions against sexual activity, prostitution, and pornography. These forms of abuse and exploitation have cascading effects on children's health and overall wellbeing (Allers, Benjack, White, & Rousey, 1993; Birdthistle et al., 2010; Kuate-Defo, 2004; Wamoyi, Wight, Plummer, Mshana, & Ross, 2010). In the past two decades, HIV/AIDS funding and research in public health, anthropology and social work have helped promote new ways of thinking about the interrelated nature of the disease and children's basic security and protection (Betancourt, Fawzi, Bruderlein, Desmond, & Kim, 2010), including the complex role that sexual abuse and exploitation may assume as both an upstream factor and downstream effect of HIV/AIDS (Kuate-Defo, 2004; Lalor, 2004; Plummer & Njuguna, 2009).

    View all citing articles on Scopus
    View full text