摘要：We examined prevalence and predictors of trauma among HIV-infected persons in the Deep South using data from the Coping with HIV/AIDS in the Southeast (CHASE) study. Over 50% of CHASE participants were abused during their lives, with approximately 30% experiencing abuse before age 13, regardless of gender. Caregiver characteristics were associated with childhood abuse. Abuse is related to increases in high–HIV-risk activities. The findings help explain why people engage in such high-risk activities and can provide guidance in designing improved care and prevention messages. Childhood sexual and severe physical abuse is associated with the following as adults: posttraumatic stress disorder, 1 – 6 anxiety, 1 – 3 depression, 7 – 11 dissociation, 4 , 7 substance abuse, 5 , 7 , 12 – 14 revictimization, 6 , 12 – 16 high-risk sexual behaviors, 7 , 17 – 20 and engaging in abuse of others. 8 Substance abuse and symptoms of mental illness are associated with reduced medication adherence, lower likelihood of being prescribed therapy, increased morbidity, and poorer quality of life among HIV-infected individuals. 21 – 30 Thus, childhood victimization can be directly linked to behaviors that put a person at risk for infectious diseases and reduced treatment adherence. Incident AIDS cases increased 29% from 2000 to 2002 in the states of Alabama, Georgia, Louisiana, North Carolina, and South Carolina, and only increased 9% across the other Southern states and less than 0.5% in the rest of the country. 31 – 32 Increases occurred most rapidly outside major metropolitan areas of these 5 states. 33 – 37 This study examines abuse rates and their associations with childhood home environments in a sample of individuals being treated for HIV in the Deep South. We believe that increased knowledge of factors leading to high-risk activities can result in effective prevention and care techniques.
