Stories of childhood sexual abuse (CSA) among older adults living with HIV (OALH) in South Carolina: a qualitative study

ABSTRACT

Childhood sexual abuse (CSA) devastatingly impacts an individual’s behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, “nobody believed me”, “cannot live like others”, lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors.

KEYWORDS:

• CSA
• HIV
• older adults
• perpetrators
• re-victimization

Acknowledgments

We are thankful for the National Institute of Mental Health Award Number K01MH115794 to support Dr. Monique Brown. I thank the co-authors of the manuscript for their valuable contribution throughout the study as well as for their assistance and expertise.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data for this study are available from Dr. Monique Brown ([email protected]) and can be provided on request from Dr. Monique Brown. The codes supporting the results of the study are available from Dr. Monique Brown or the correspondence author (AK) upon a reasonable request.

Additional information

Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number K01MH115794. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.