A sexual risk and stress reduction intervention designed for HIV-positive bisexual African American men with childhood sexual abuse histories

J.K. Williams, D.A. Glover, G.E. Wyatt, K. Kisler, H. Liu and M. Zhang

American Journal of Public Health, 2013, vol. 103, issue 8, 1476-1484

Abstract: Objectives. HIV transmission risk is high among men who have sex with men and women (MSMW), and it is further heightened by a history of childhood sexual abuse (CSA) and current traumatic stress or depression. Yet, traumatic stress is rarely addressed in HIV interventions. We tested a stress-focused sexual risk reduction intervention for African American MSMW with CSA histories. Methods. This randomized controlled trial compared a stress-focused sexual risk reduction intervention with a general health promotion intervention. Sexual risk behaviors, psychological symptoms, stress biomarkers (urinary cortisol and catecholamines), and neopterin (an indicator of HIV progression) were assessed at baseline and at 3- and 6-month follow-ups. Results. Both interventions decreased and sustained reductions in sexual risk and psychological symptoms. The stress-focused intervention was more efficacious than the general health promotion intervention in decreasing unprotected anal insertive sex and reducing depression symptoms. Despite randomization, baseline group differences in CSA severity, psychological symptoms, and biomarkers were found and linked to subsequent intervention outcomes. Conclusions. Although interventions designed specifically for HIV-positive African American MSMW can lead to improvements in health outcomes, future research is needed to examine factors that influence intervention effects. © 2013 American Journal of Public Health.

Keywords: biological marker; catecholamine; hydrocortisone; neopterin, African American; analysis of variance; article; bisexuality; chi square distribution; child abuse; controlled clinical trial; controlled study; disease transmission; health promotion; human; Human immunodeficiency virus infection; intervention study; male; methodology; middle aged; posttraumatic stress disorder; psychological aspect; questionnaire; randomized controlled trial; risk reduction; sexual behavior; urine, Adult Survivors of Child Abuse; African Americans; Analysis of Variance; Biological Markers; Bisexuality; Catecholamines; Chi-Square Distribution; Health Promotion; HIV Infections; Humans; Hydrocortisone; Intervention Studies; Male; Middle Aged; Neopterin; Questionnaires; Risk Reduction Behavior; Sexual Behavior; Stress Disorders, Post-Traumatic (search for similar items in EconPapers)
Date: 2013
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Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.301121_0

DOI: 10.2105/AJPH.2012.301121

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