Childhood abuse and initial presentation for HIV care: an opportunity for early intervention.

TitleChildhood abuse and initial presentation for HIV care: an opportunity for early intervention.
Publication TypeJournal Article
Year of Publication2007
AuthorsMugavero MJ, Pence BW, Whetten K, Leserman J, Swartz M, Stangl D, Thielman NM
JournalAIDS Care
Volume19
Issue9
Pagination1083-7
Date Published2007 Oct
ISSN0954-0121
KeywordsAdolescent, Adult, Anti-HIV Agents, Child, Child Abuse, Sexual, Cohort Studies, Female, HIV Infections, Humans, Male, Patient Acceptance of Health Care, Prospective Studies, Risk-Taking, Sexual Behavior
Abstract

An alarmingly high prevalence of childhood sexual and physical abuse has been observed in HIV-infected men and women, with rates several times higher than observed in the general population. Childhood abuse history has been associated with worse antiretroviral adherence and negative health behaviours in HIV-infected patients. This study evaluates the relationship between childhood abuse and the timing of presentation for HIV care. Participants in a multi-center prospective cohort study, who established initial HIV care after January 1996 and had a CD4 count available within six months of initial presentation, were included in this analysis. Bivariate contingency tables and multivariate logistic regression were used to evaluate the association of childhood abuse with early presentation for HIV care (initial CD4 count > or =200/mm3). Among the 186 subjects included in this analysis, 33% had childhood abuse histories and 58% had an initial CD4 count > or =200/mm3. Participants with a history of childhood abuse were more likely to present early for HIV care (AOR=2.12; p=0.03), perhaps because survivors of abuse tend to have higher utilization of health services. Because HIV-infected patients with childhood abuse histories have worse antiretroviral medication adherence and are more likely to engage in high-risk sexual and injection drug use behaviours, early presentation affords clinicians the opportunity for timely institution of interventions that may improve patient outcomes and prevent secondary HIV infections.

DOI10.1080/09540120701351896
Alternate JournalAIDS Care
PubMed ID18058391
Grant List5R01MH061687-05 / MH / NIMH NIH HHS / United States
U01 AI069484 / AI / NIAID NIH HHS / United States