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

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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.

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Acknowledgments

This study was funded by grant No. 5-K01MH070278 from the National Institutes of Health through the National Institute of Mental Health (G. Clum). Additional funding and support was provided by The Adolescent Trials Network for HIV/AIDS Interventions (ATN) which is funded by grant No. U01 HD40533 from the National Institutes of Health through the National Institute of Child Health and Human Development (A. Rogers, R. Nugent, L. Serchuck), with supplemental funding from the National Institutes on Drug Abuse (N. Borek), Mental Health (A. Forsyth, P. Brouwers), and Alcohol Abuse and Alcoholism (K. Bryant). We acknowledge the contribution of the investigators and staff at the following ATN sites that participated in this study: Montefiore Medical Center, Bronx, NY (D. Futterman, E. Enriquez-Bruce, M. Campos); University of Miami School of Medicine, Division of Adolescent Medicine, Miami, FL (L. Friedman, D. Maturo, H. Major Wilson); Children’s Hospital of Philadelphia, Philadelphia, PA (B. Rudy, M. Tanney, N. Seth). The study was scientifically reviewed by the ATN’s scientifically reviewed by the ATN’s Behavioral Leadership Group. Network scientific and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow), at University of Alabama at Birmingham. Network operations and analytic support was provided by the ATN Data and Operations Center at Westat, Inc. (J. Ellenberg, K. Joyce, J. Davidson, R. Mitchell). The investigators are grateful to the members of the ATN Community Advisory Board for their insight and counsel and are particularly indebted to the youth who participated in this study.

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Authors and Affiliations

  1. Department of Community Health Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2301, New Orleans, LA, 70112, USA

    Gretchen A. Clum & Lauren Hamvas

  2. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Shang-En Chung & Jonathan M. Ellen

  3. Westat, Washington, DC, USA

    Lori V. Perez

  4. Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA

    Debra A. Murphy

  5. Department of Psychology, DePaul University, Chicago, IL, USA

    Gary W. Harper

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  1. Gretchen A. Clum
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  2. Shang-En Chung
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  3. Jonathan M. Ellen
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  5. Debra A. Murphy
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  7. Lauren Hamvas
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Correspondence to Gretchen A. Clum.

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Clum, G.A., Chung, SE., Ellen, J.M. et al. Victimization and Sexual Risk Behavior in Young, HIV Positive Women: Exploration of Mediators. AIDS Behav 16, 999–1010 (2012). https://doi.org/10.1007/s10461-011-9931-0

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