Trauma Fuels HIV Epidemic Among Women

UCSF helped create a theater workshop for HIV-positive women suffering from trauma (From left to right: Cassandra Steptoe, Edward Machtinger & Rhodessa Jones. Photo courtesy of UCSF).

UCSF helped create a theater workshop for HIV-positive women suffering from PTSD and other forms of trauma. From left to right: theater participant Cassandra Steptoe, UCSF Professor Edward Machtinger & Rhodessa Jones of the theater group Cultural Odyssey. (Photo: UCSF).

Scientists know that women who have been traumatized or suffer from post-traumatic stress disorder (PTSD) are more likely to be at risk for HIV.

Now two new studies published in the journal AIDS and Behavior show that HIV-positive women suffer disproportionately high rates of trauma and PTSD. In a vicious circle, the high rates of trauma lead to increased risk of further spreading the illness.

In the first study researchers at U.C. San Francisco and Harvard Medical School looked at nearly 6,000 HIV-positive women. They found HIV-positive women were twice as likely to experience violence from their partner and five times more likely to suffer from PTSD than the national average.

In the second smaller study of 113 HIV-positive women, researchers reported that women experiencing ongoing trauma were about four times more likely both to have unsafe sex and to fail taking antiretroviral medications correctly.

That combination of skipping medication and unsafe sex leads to alarming public health consequences, says lead author Edward Machtinger, who directs UCSF’s Women’s HIV Program. He said if a woman isn’t taking HIV medications properly, she is more infectious.

“Our hope is that screening for trauma and intervening for trauma becomes a required aspect of the care for all women with HIV.”

“And if that person is having unprotected sex with HIV-negative partners,” Machtinger told me, “that is a situation that predisposes further transmission more than any other. The conclusion that we come to is that trauma fuels all aspects of the HIV epidemic among women.”

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