The Effects of Childhood Sexual Abuse: The Role of Anxiety and Alcohol Use among Haitian Women Living with HIV

ABSTRACT

Childhood abuse has been linked to problematic drinking in adulthood. It is also documented that people living with HIV have higher rates of alcohol use than the general population. In Haiti, a total of 25% of women living with HIV have experienced childhood sexual abuse (CSA), which puts them at an increased risk for alcohol abuse. CSA has also been associated with anxiety disorders in adulthood. Therefore, it is critical to understand the relationship between CSA, anxiety, and alcohol use among women living with HIV. A total of 244 women living with HIV participated in this study, with 35% reporting CSA. Alcohol abuse was measured with the AUDIT, anxiety with the State-Trait Anxiety Inventory test, and sexual abuse with the Childhood Trauma Questionnaire. Compared to participants who did not experience childhood sexual abuse, participants who experienced childhood sexual abuse reported greater levels of alcohol use [(17.0, SD = 9.1) (11.9, SD = 8.6) p =.001] and anxiety [(55.8, SD = 9.8) (48.9 SD = 8.3) p =.001] respectively. The indirect effect of anxiety on the association between CSA and alcohol use was significant [(ß =.19 p =.05) 95% bootstrap CI.019 –.13] Thus, women who reported being sexually abused as children reported anxiety, which in turn, was associated with an increased risk for alcohol abuse. Results demonstrate that alcohol may be used as a negative coping mechanism to alleviate anxiety symptoms triggered by CSA. These findings elucidate the need for further research examining the impact that sexual trauma has on mental health.

KEYWORDS:

• HIV
• women
• sexual trauma
• risk behaviors
• childhood sexual abuse
• anxiety
• alcohol abuse

Declaration of interest statement

All authors declare no conflict of interest

Additional information

Funding

This research was supported by Grant R01 AA018084 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Notes on contributors

Karina Villalba

Karina Villalba, MPH, Ph.D., is an Assistant Professor in Population Health in the College of Medicine at the University of Central Florida. Her research focuses in the areas of HIV prevention and associated comorbidities such as substance use, prevention intervention development to improve sexual health and coping with trauma, and genetic and social environmental factors in neurocognition that may moderate the effectiveness of prevention and treatment strategies.

Jennifer Attonito

Jennifer Attonito, Ph.D., is an Instructor in the College of Business in Managements Programs and Health Administration at Florida Atlantic University. Her area of research includes addiction and mental health services and policy research, including the effectiveness of programs, policy analysis, and cost-effectiveness studies of service and reimbursement models.

Michele Jean-Gilles

Michèle Jean-Gilles, Ph.D., is a Research Assistant Professor in the Department of Health Promotion and Disease Prevention at Florida International University, her research interests include primary and secondary prevention of HIV, the reduction of other health disparities affecting underserved populations, and cross-cultural psychology. She has expertise in conducting group and family interventions for HIV/AIDS infected and affected individuals and has published in this area.

Rhonda Rosenberg

Rhonda Rosenberg Ph.D., is a Research Assistant Professor in the Department of Health Promotion and Disease Prevention at Florida International University. Dr. Rosenberg has focused on the development and optimization of intervention strategies for the prevention and treatment of HIV and related mental health and substance use comorbidities, in which the central question has been how to reach the most vulnerable populations.

Mariana Sanchez

Mariana Sanchez, PhD., Mariana Sanchez is an Assistant Professor in the Department of Health Promotion and Disease Prevention in the Robert Stempel College of Public Health and Social Work at Florida International University. She has over 20 years of experience in conducting longitudinal research with youth and young adults in Miami-Dade County, Florida. Her program of research seeks to gain a deeper understanding of the cultural mechanism that influences health behaviors, particularly alcohol misuse, and its related consequences among Latinos.

Jessy Devieux

Jessy Dévieux, Ph.D., is a Clinical and Health Psychologist and Professor in the Department of Health Promotion and Disease Prevention at Florida International University. Her research interests focus on health disparities among racial and ethnic minorities, especially the development and adaptation of HIV primary and secondary prevention interventions for underserved populations in the U.S. and internationally.