Skip to main content

Advertisement

Log in

Caring for Persons with Early Childhood Trauma, PTSD, and HIV: a Curriculum for Clinicians

  • Column: Educational Case Report
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Access and adherence to medical care enable persons with HIV to live longer and healthier lives. Adherence to care improves quality of life, prevents progression to AIDS, and also has significant public health implications. Early childhood trauma-induced posttraumatic stress disorder (PTSD) is one factor that has been identified as an obstacle to adherence to both risk reduction and HIV care. The authors developed a 4-h curriculum to provide clinicians with more confidence in their ability to elicit a trauma history, diagnose PTSD, and address trauma and its sequelae in persons with HIV to improve adherence to medical care, antiretroviral medications, and risk reduction. The curriculum was designed to address the educational needs of primary care physicians, infectious disease specialists, psychiatrists, other specialists, psychologists, social workers, nurses, residents, medical students, and other trainees who provide care for persons infected with and affected by HIV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Allers C, Benjack K, White J, Rousey J. HIV vulnerability and the adult survivor of childhood sexual abuse. Child Abuse Negl. 1993;17:291–8.

    Article  CAS  PubMed  Google Scholar 

  2. Carballo-Diéguez A, Dolezal C. Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. Child Abuse Negl. 1995;19:595–605.

    Article  PubMed  Google Scholar 

  3. Goodman L, Fallot R. HIV risk-behavior in poor urban women with serious mental disorders: association with childhood physical and sexual abuse. Am J Orthopsychiatry. 1998;68:73–83.

    Article  CAS  PubMed  Google Scholar 

  4. Lenderking W, Wold C, Mayer K, et al. Childhood sexual abuse among homosexual men. Prevalence and association with unsafe sex. J Gen Intern Med. 1997;12:250–3.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Thompson S, Hocking B, Checkley G, et al. Sexually transmitted diseases and unwanted pregnancies in chronically ill psychiatric patients. Med J Aust. 1997;166:666.

    CAS  PubMed  Google Scholar 

  6. Wingood G, DiClemente R. Child sexual abuse, HIV sexual risk, and gender relations of African-American women. Am J Prev Med. 1997;13:380–4.

    CAS  PubMed  Google Scholar 

  7. Allers C, Benjack K. Connection between childhood abuse and HIV Infection. J Couns Dev. 1991;70:309–13.

    Article  Google Scholar 

  8. James J, Meyerding J. Early sexual experience and prostitution. Am J Psychiatry. 1977;134:1381–5.

    CAS  PubMed  Google Scholar 

  9. Samuels E, Khalife S, Alfonso C, et al. Early childhood trauma, posttraumatic stress disorder, and non-adherence in persons with AIDS: a psychodynamic perspective. J Am Acad Psychoanal Dyn Psychiatry. 2011;39:633–50.

    Article  PubMed  Google Scholar 

  10. Ybarra M, Mitchell K. Prevalence rates of male and female sexual violence perpetrators in a national sample of adolescents. JAMA Pediatr. 2013;167:1125–34.

    Article  PubMed  Google Scholar 

  11. Cohen MS, Gay C, Kashuba AD, Blower S, Paxton L. Narrative review: antiretroviral therapy to prevent the sexual transmission of HIV-1. Ann Intern Med. 2007;146:591–601.

    Article  PubMed  Google Scholar 

  12. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet. 2009;373:48–57.

    Article  PubMed  Google Scholar 

  13. Dieffenbach CW, Fauci AS. Universal voluntary testing and treatment for prevention of HIV transmission. JAMA. 2009;301:2380–2.

    Article  CAS  PubMed  Google Scholar 

  14. Kalichman SC, Di Berto G, Eaton L. Human immunodeficiency virus viral load in blood plasma and semen: review and implications of empirical findings. Sex Transm Dis. 2008;35:55–60.

    Article  PubMed  Google Scholar 

  15. Gillespie C, Bradley B, Mercer K, et al. Trauma exposure and stress-related disorders in inner city primary care patients. Gen Hosp Psychiatry. 2009;31:505–14.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Machtinger E, Wilson T, Haberer J, Weiss D. Psychological trauma and PTSD in HIV-positive women: a meta-analysis. AIDS Behav. 2012;16:2091–100.

    Article  CAS  PubMed  Google Scholar 

  17. Boarts JM, Buckley-Fischer BA, Armelie AP, Bogart LM, Delahanty DL. The impact of HIV diagnosis-related vs. non-diagnosis related trauma on PTSD, depression, medication adherence, and HIV disease markers. J Evid Based Soc Work. 2009;6:4–16.

    Article  PubMed  Google Scholar 

  18. Boarts J, Sledjeski E, Bogart L, et al. The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV. AIDS Behav. 2006;10:253–61.

    Article  PubMed  Google Scholar 

  19. Vranceanu A, Safren S, Lu M, et al. The relationship of post-traumatic stress disorder and depression to antiretroviral medication adherence in persons with HIV. AIDS Patient Care STDS. 2009;22:313–21.

    Article  Google Scholar 

  20. Sledjeski E, Delahanty D, Bogart L. Incidence and impact of posttraumatic stress disorder and comorbid depression on adherence to HAART and CD4+ counts in people living with HIV. AIDS Patient Care STDS. 2005;19:728–36.

    Article  PubMed  Google Scholar 

  21. Atkinson J, Grant I, Kennedy CJ, Richman DD, Spector SA, McCutchan J. Prevalence of psychiatric disorders among men infected with human immunodeficiency virus: a controlled study. Arch Gen Psychiatry. 1988;45:859–64.

    Article  PubMed  Google Scholar 

  22. Rabkin JG, Ferrando SJ, Jacobsberg LB, Fishman B. Prevalence of axis I disorders in an AIDS cohort: a cross-sectional, controlled study. Compr Psychiatry. 1997;38:146–54.

    Article  CAS  PubMed  Google Scholar 

  23. Bing EG, Burnam M, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58:721–8.

    Article  CAS  PubMed  Google Scholar 

  24. Lyketsos C. Screening for psychiatric morbidity in a medical outpatient clinic for HIV infection: the need for a psychiatric presence. Int J Psychiatry Med. 1994;24:103–13.

    Article  CAS  PubMed  Google Scholar 

  25. Lyketsos C, Fishman M, Hutton H, et al. The effectiveness of psychiatric treatment for HIV-infected patients. Psychosomatics. 1997;38:423–32.

    Article  CAS  PubMed  Google Scholar 

  26. Cohen MA. Psychiatric care in an AIDS nursing home. Psychosomatics. 1998;39:154–61.

    Article  CAS  PubMed  Google Scholar 

  27. APM AIDS Psychiatry Special Interest Group. Academy of Psychosomatic Medicine; 2013; Available from: http://www.apm.org/sigs/oap/.

  28. Trauma, PTSD, and HIV. Charles R. Drew University of Medicine and Science; 2010–2012; available at: http://hivtrainingcdu.org/hivandptsd. Accessed 04 Apr 2014.

  29. Levenson J. The American Psychiatric Publishing textbook of psychosomatic medicine. 2nd ed. Arlington: American Psychiatric Publishing, Inc.; 2011.

    Google Scholar 

  30. Stern T. Massachusetts general hospital handbook of general hospital psychiatry. 6th ed. Philadelphia: Saunders; 2010.

    Google Scholar 

  31. Zigmond A, Snaith R. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.

    Article  CAS  PubMed  Google Scholar 

  32. Cohen MA, Alfonso C, Hoffman R, et al. The impact of PTSD on treatment adherence in persons with HIV infection. Gen Hosp Psychiatry. 2001;23:294–6.

    Article  CAS  PubMed  Google Scholar 

  33. Francisco Ricart F, Cohen MA, Alfonso C, et al. Understanding the psychodynamics of non-adherence to medical treatment in persons with HIV infection. Gen Hosp Psychiatry. 2002;24:176–80.

    Article  PubMed  Google Scholar 

  34. Cohen MA, Hoffman R, Cromwell C, et al. The prevalence of distress in persons with human immunodeficiency virus infection. Psychosomatics. 2002;43:10–5.

    Article  PubMed  Google Scholar 

  35. Cohen MA, Goforth H, Lux J, et al. Handbook of AIDS psychiatry. New York: Oxford University Press; 2010.

    Google Scholar 

  36. Adult survivors of child abuse: survivor to thriver. San Francisco: The Morris Center, 2007. Available at http://www.ascasupport.org/manual.php. Accessed 04 Apr 2014.

Download references

Disclosures

The authors have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mary Ann Cohen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tavakkoli, M., Cohen, M.A., Alfonso, C.A. et al. Caring for Persons with Early Childhood Trauma, PTSD, and HIV: a Curriculum for Clinicians. Acad Psychiatry 38, 696–700 (2014). https://doi.org/10.1007/s40596-014-0186-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40596-014-0186-8

Keywords

Navigation