The impact of shame on health-related quality of life among HIV-positive adults with a history of childhood sexual abuse.

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2010-09

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Abstract

Childhood sexual abuse is prevalent among people living with HIV, and the experience of shame is a common consequence of childhood sexual abuse and HIV infection. This study examined the role of shame in health-related quality of life among HIV-positive adults who have experienced childhood sexual abuse. Data from 247 HIV-infected adults with a history of childhood sexual abuse were analyzed. Hierarchical linear regression was conducted to assess the impact of shame regarding both sexual abuse and HIV infection, while controlling for demographic, clinical, and psychosocial factors. In bivariate analyses, shame regarding sexual abuse and HIV infection were each negatively associated with health-related quality of life and its components (physical well-being, function and global well-being, emotional and social well-being, and cognitive functioning). After controlling for demographic, clinical, and psychosocial factors, HIV-related, but not sexual abuse-related, shame remained a significant predictor of reduced health-related quality of life, explaining up to 10% of the variance in multivariable models for overall health-related quality of life, emotional, function and global, and social well-being and cognitive functioning over and above that of other variables entered into the model. Additionally, HIV symptoms, perceived stress, and perceived availability of social support were associated with health-related quality of life in multivariable models. Shame is an important and modifiable predictor of health-related quality of life in HIV-positive populations, and medical and mental health providers serving HIV-infected populations should be aware of the importance of shame and its impact on the well-being of their patients.

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10.1089/apc.2009.0209

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Persons, Elizabeth, Trace Kershaw, Kathleen J Sikkema and Nathan B Hansen (2010). The impact of shame on health-related quality of life among HIV-positive adults with a history of childhood sexual abuse. AIDS Patient Care STDS, 24(9). pp. 571–580. 10.1089/apc.2009.0209 Retrieved from https://hdl.handle.net/10161/3237.

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Sikkema

Kathleen J. Sikkema

Research Professor in the Department of Psychology and Neuroscience

Kathleen J. Sikkema, Ph.D., Gosnell Family Professor of Global Health, Psychology and Neuroscience, and Psychiatry and Behavioral Sciences at Duke University, is a clinical psychologist with emphases in health and community psychology. She is the Director of Doctoral Studies at the Duke Global Health Institute (DGHI), Director of the Social and Behavioral Science Core in Duke's Center for AIDS Research (CFAR), and Director of the Global Mental Health Initiative at DGHI

Dr. Sikkema, an expert in randomized, controlled HIV prevention and mental health intervention trials, has been supported by the National Institutes of Health (NIH) for over 25 years. She conducts research on the development of HIV-related mental health interventions focused on traumatic stress and coping. Sikkema's intervention programs have been recognized by the CDC as "best evidence interventions" as well as the National Registry of Evidence-based Programs and Practices (NREPP).

Dr. Sikkema's research is also focused on the development and evaluation of HIV risk behavior change interventions, with expertise in community-level intervention trials and university-community collaboration. She recently developed and evaluated a brief risk reduction intervention (PC: Positive Choices), in collaboration with the Callen Lorde Community Health Center, for those newly diagnosed with HIV, with implications for engagement in care and HIV prevention.

Dr. Sikkema's current research is focused in South Africa, collaborating with various South African universities since 2001. Building on prior work with abused women, she recently completed a multi-method longitudinal study to inform development of innovative intervention approaches related to gender, HIV risk and alcohol use in South Africa. Dr. Sikkema's current efforts are focused on the development of mental health interventions that address the intersection of HIV care engagement and HIV prevention.


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