Childhood Sexual Trauma, Substance Use, and Antiretroviral Therapy Adherence Among Older Adults Living With HIV: A Mediational Analysis

Overview

Journal J Appl Gerontol

Specialties Geriatrics
Infectious Diseases

Date 2024 Sep 24

PMID 39316826

Authors

Monique J Brown

Josie Zhang

Prince Nii Ossah Addo

Amandeep Kaur

Daniel Amoatika

Elizabeth Crouch

Steven A Cohen

Affiliations

Soon will be listed here.

Abstract

Childhood sexual abuse (CSA) is linked to substance use and lower antiretroviral therapy (ART) adherence. However, studies examining the mediational role of substance use between CSA and ART adherence are lacking. Therefore, the aim of this study was to determine the potential mediational role of substance use between CSA and ART adherence among older adults living with HIV (OALH) ( = 91). Mediation analyses assessed the direct and indirect relationships between CSA, substance use, and ART adherence. Statistically significant differences existed in substance use by gender (male vs. female: 12.3 vs. 9.97) and ART adherence by race (Black vs. White: 98.2% vs. 99.6%) and employment. CSA was associated with ART adherence (β = -3.27, < .001) and substance use (β = 2.14, = .035), but substance use was not associated with ART adherence, and did not mediate the pathway between CSA and ART adherence in the adjusted model. Trauma-informed interventions may lower substance use among OALH with CSA.

References

Brown M, Masho S, Perera R, Mezuk B, Pugsley R, Cohen S . Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors. AIDS Behav. 2016; 21(6):1550-1566. PMC: 5896316. DOI: 10.1007/s10461-016-1553-0. View

Sikkema K, Choi K, Robertson C, Knettel B, Ciya N, Knippler E . Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories. Eval Program Plann. 2018; 68:148-156. PMC: 5953816. DOI: 10.1016/j.evalprogplan.2018.02.007. View

Blanco J, Caro A, Perez-Cachafeiro S, Gutierrez F, Iribarren J, Gonzalez-Garcia J . HIV infection and aging. AIDS Rev. 2010; 12(4):218-30. View

Brousseau N, Kalichman S, Watson R, Eaton L . Amphetamine use and its associations with antiretroviral adherence and viral load among sexual minority men and transgender women living with HIV. AIDS Care. 2023; 35(10):1472-1479. PMC: 10524564. DOI: 10.1080/09540121.2023.2206096. View

Draper B, Pfaff J, Pirkis J, Snowdon J, Lautenschlager N, Wilson I . Long-term effects of childhood abuse on the quality of life and health of older people: results from the Depression and Early Prevention of Suicide in General Practice Project. J Am Geriatr Soc. 2007; 56(2):262-71. DOI: 10.1111/j.1532-5415.2007.01537.x. View

Lotzin A, Grundmann J, Hiller P, Pawils S, Schafer I . Profiles of Childhood Trauma in Women With Substance Use Disorders and Comorbid Posttraumatic Stress Disorders. Front Psychiatry. 2019; 10:674. PMC: 6813657. DOI: 10.3389/fpsyt.2019.00674. View

Walsh J, Mandalia S, Gazzard B . Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. AIDS. 2002; 16(2):269-77. DOI: 10.1097/00002030-200201250-00017. View

Brown M, Amoatika D, Addo P, Kaur A, Haider M, Merrell M . Childhood Sexual Trauma and Subjective Cognitive Decline: An Assessment of Racial/Ethnic and Sexual Orientation Disparities. J Appl Gerontol. 2023; 42(10):2129-2138. PMC: 10523896. DOI: 10.1177/07334648231175299. View

Zhang Y, Wilson T, Adedimeji A, Merenstein D, Milam J, Cohen J . The Impact of Substance Use on Adherence to Antiretroviral Therapy Among HIV-Infected Women in the United States. AIDS Behav. 2017; 22(3):896-908. PMC: 5709246. DOI: 10.1007/s10461-017-1808-4. View

10.

Liu H, Longshore D, Williams J, Rivkin I, Loeb T, Warda U . Substance abuse and medication adherence among HIV-positive women with histories of child sexual abuse. AIDS Behav. 2006; 10(3):279-86. PMC: 4398018. DOI: 10.1007/s10461-005-9041-y. View

11.

Kroenke K, Spitzer R, Williams J . The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9):606-13. PMC: 1495268. DOI: 10.1046/j.1525-1497.2001.016009606.x. View

12.

Harrison S, Brown M, Cho H . Links between sexual trauma exposure and Quality of Life (QoL) domains among people living with HIV in the Southern United States. AIDS Care. 2020; 32(sup2):91-98. PMC: 7213510. DOI: 10.1080/09540121.2020.1739215. View

13.

Markowitz S, OCleirigh C, Hendriksen E, Bullis J, Stein M, Safren S . Childhood sexual abuse and health risk behaviors in patients with HIV and a history of injection drug use. AIDS Behav. 2010; 15(7):1554-60. PMC: 3638763. DOI: 10.1007/s10461-010-9857-y. View

14.

Weinstein E, Lozano A, Jones M, Jimenez D, Safren S . Factors Associated with Antiretroviral Therapy Adherence Among a Community-Based Sample of Sexual Minority Older Adults with HIV. AIDS Behav. 2023; 27(10):3285-3293. PMC: 11299000. DOI: 10.1007/s10461-023-04048-6. View

15.

Watt M, Dennis A, Choi K, Ciya N, Joska J, Robertson C . Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa. AIDS Behav. 2016; 21(11):3209-3218. PMC: 5438301. DOI: 10.1007/s10461-016-1617-1. View

16.

Brown M, Adeagbo O . HIV and Aging: Double Stigma. Curr Epidemiol Rep. 2021; 8(2):72-78. PMC: 7952834. DOI: 10.1007/s40471-021-00265-6. View

17.

Hines L, Jones H, Hickman M, Lynskey M, Howe L, Zammit S . Adverse childhood experiences and adolescent cannabis use trajectories: findings from a longitudinal UK birth cohort. Lancet Public Health. 2023; 8(6):e442-e452. PMC: 10751739. DOI: 10.1016/S2468-2667(23)00095-6. View

18.

Amoatika D, Brown M, Addo P, Kaur A . Coping strategies among older adults living with HIV/AIDS with history of childhood sexual abuse. Int J STD AIDS. 2023; 34(10):687-693. DOI: 10.1177/09564624231173030. View

19.

Kaswa R, De Villiers M . The effect of substance uses on antiretroviral treatment adherence in primary health care. S Afr Fam Pract (2004). 2023; 65(1):e1-e8. PMC: 10091189. DOI: 10.4102/safp.v65i1.5660. View

20.

Meade C, Hansen N, Kochman A, Sikkema K . Utilization of medical treatments and adherence to antiretroviral therapy among HIV-positive adults with histories of childhood sexual abuse. AIDS Patient Care STDS. 2009; 23(4):259-66. PMC: 2856435. DOI: 10.1089/apc.2008.0210. View