New research from Duke University shows that psychological trauma predicts increased vulnerability for HIV/AIDS and faster health decline.


PROBLEM: Does child abuse increase the likelihood of HIV infection and subsequent disease mismanagement?

METHODOLOGY: Duke University researchers led by Brian Pence monitored more than 600 HIV-positive patients, aged 20 to 71, in the "Coping with HIV/AIDS in the Southeast" study. They investigated possible links to traumatic experiences, HIV-related behaviors, and health outcomes.

RESULTS: A quarter of the respondents were sexually abused as children. Moreover, half of the patients had faced three or more traumatic experiences in their lifetime, including enduring physical abuse and witnessing domestic violence as a child, living through a parent's suicide attempt or completion, or losing a child.

These painful experiences predicted worse health-related behaviors, such as instances of unprotected sex, missed antiretroviral medications, recent emergency room visits, and hospitalizations. Those who lived through such ordeals were also more likely to die or see their health decline during the two-year study period.

CONCLUSION: Psychological trauma heightens the risk for HIV infection, medication lapses, and disease progression.

IMPLICATION: Addressing the psychosocial barriers to effective disease management and evaluating the mental history of patients receiving HIV care are vital. "Regardless of the reason," said Pence in a statement, "past trauma certainly seems to influence how HIV patients engage in their medical care and how they end up doing clinically."

SOURCE: The full study, "Childhood Trauma and Health Outcomes in HIV-Infected Patients: An Exploration of Causal Pathways," is published in the Journal of Acquired Immune Deficiency Syndromes.