Childhood Sexual Abuse, African American Women, and HIV Risk

  • Lekeisha A. Sumner
  • Gail E. Wyatt
  • Dorie Glover
  • Jennifer V. Carmona
  • Tamra B. Loeb
  • Tina B. Henderson
  • Dorothy Chin
  • Rotrease S. Regan


Child sexual abuse (CSA) is defined as unwanted or coerced sexual contact prior to the age of 18 (Wyatt, 1985; Wyatt, Newcomb, & Riederle, 1995). Once thought to rarely occur, conservative estimates suggest that at least 20% of women and 5–10% of men worldwide report being sexually abuse as children (World Health Organization, 2002). Within the United States, the prevalence of CSA among women is approximately 33% (Briere & Elliott, 1993; Loeb et al., 2002a; Wyatt, Guthrie, & Notgrass, 1992). A large body of epidemiological evidence suggests that the impact of childhood sexual abuse is varied and wide-reaching. Further, a history of childhood sexual abuse is linked to increased risks for psychosocial, behavioral, and physical health problems, including HIV (Chin, Wyatt, Carmona, Loeb, & Myers, 2004).


Intimate Partner Violence Sexual Abuse African American Woman Childhood Sexual Abuse Ptsd Symptom 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Preparation of this chapter was supported by the National Institute of Mental Health (H059496-0451 and MH073453-01A1), the UCLA AIDS Institute (A128697), National Institute on Drug Abuse, (DA 01070-31), and National Institute on Drug Abuse (DA 01070-34). The first author was supported by a UCLA Psychobiology Fellowship (NIMH grant T32 MH17140) and The Pittsburgh Mind-Body Center (PMBC; NIH grant HL076852/076858). The authors acknowledge Micha Dalton and Tanishia Wright for their assistance in the preparation of this manuscript.


  1. Amaro, H. (1995). Love, sex, and power: considering women’s realities in HIV prevention. The American Psychologist, 50(6), 437–447.PubMedCrossRefGoogle Scholar
  2. Amaro, H., Jianyu, D., Arevalo, S., Acevedo, A., Matsumoto, A., Nieves, R., et al. (2007). Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 84(4), 508–522.Google Scholar
  3. Amaro, H., & Raj, A. (2000). On the margin: power and women’s HIV risk reduction strategies. Sex Roles, 42(7–8), 723–749.CrossRefGoogle Scholar
  4. Axelrod, J., Myers, H. F., Durvasula, R. S., Wyatt, G. E., & Cheng, M. (1999). The impact of relationship violence, HIV, and ethnicity on adjustment in women [Special issue: HIV/AIDS and ethnic minority women, families, and communities]. Cultural Diversity and Ethnic Minority Psychology, 3, 263–275.CrossRefGoogle Scholar
  5. Baker, S. A., Beadnell, B., Stoner, S., Morrison, D. M., Gordon, J., Collier, C., et al. (2003). Skills training versus health education to prevent STDs/HIV in heterosexual women: a randomized controlled trial utilizing biological outcomes. AIDS Education and Prevention, 15(1), 1–14.PubMedCrossRefGoogle Scholar
  6. Bensley, L. S., Eenwyk, J. V., & Simmons, K. W. (2000). Self-reported childhood sexual and ­physical abuse and adult HIV-risk behaviors and heavy drinking. American Journal of Preventive Medicine, 18(2), 151–158.PubMedCrossRefGoogle Scholar
  7. Blankertz, L., Cnann, R., & Freedman, E. (1993). Childhood Risk Factors in Dually Diagnosed Homeless Adults. Social Work, 38(5), 587–596.PubMedGoogle Scholar
  8. Boudewyn, A. C., & Liem, J. H. (1995). Childhood sexual abuse as a precursor to depression and self-destructive behavior in adulthood. Journal of Traumatic Stress, 8(3), 445–459.PubMedCrossRefGoogle Scholar
  9. Briere, J. (2004). Integrating HIV/AIDS prevention activities into psychotherapy for child sexual abuse survivors. In L. J. Koenig & L. S. Doll (Eds.), From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention (pp. 219–232). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  10. Briere, J., & Elliott, D. M. (1993). Sexual abuse, family environment, and psychological symptoms: On the validity of statistical control. Journal of Consulting and Clinical Psychology, 61(2), 284–288.PubMedCrossRefGoogle Scholar
  11. Briere, J., Runtz, M. (1988). Post sexual abuse trauma. In G. E. Wyatt, & G. J. Powell (Eds.), Lasting effects of child sexual abuse (Sage focus editions), Vol. 100 (pp. 85-99). Thousand Oaks: Sage.Google Scholar
  12. Cargill, V. A., Stone, V. E., & Robinson, M. R. (2004). HIV treatment in African Americans: Challenges and opportunities. Journal of Black Psychology, 30(1), 24–39.CrossRefGoogle Scholar
  13. Carrion, V. G., Weems, C. F., Garret, A., Mennon, V., & Reiss, A. L. (2007). Posttraumatic stress symptoms and brain function during a response-inhibition task: an fMRI study in youth. Depression and Anxiety, 25(6), 514–526.CrossRefGoogle Scholar
  14. Center for Disease Control and Prevention. (1997). HIV prevention case management – guidance. Retrieved 26.06.2006.
  15. Center for Disease Control and Prevention. (2005). HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men – five U.S. cities, June 2004–April 2005. MMWR. Morbidity and Mortality Weekly Report, 54(24), 597–601.Google Scholar
  16. Centers for Disease Control and Prevention. (2007). HIV surveillance report: AIDS cases by race and ethnicity.
  17. Chin, D., & Kroesen, K. W. (1999). Disclosure of HIV infection among Asian/Pacific Islander American women: cultural stigma and support [Special issue: HIV/AIDS and ethnic minority women, families, and communities]. Cultural Diversity and Ethnic Minority Psychology, 5(3), 222–235.CrossRefGoogle Scholar
  18. Chin, D., Wyatt, G. E., Carmona, J. V., Loeb, T. B., & Myers, H. F. (2004). Child sexual abuse and HIV: An integrative risk-reduction approach. In L. J. Koenig & L. S. Doll (Eds.), From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention (pp. 233–250). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  19. Cloitre, M., Scarvalone, P., & Difede, J. (1997). Posttraumatic stress disorder, self- and interpersonal dysfunction among sexually retraumatized women. Journal of Traumatic Stress, 10(3), 437–452.PubMedGoogle Scholar
  20. Coe, C. L., & Laudenslager, M. L. (2007). Psychosocial influence on immunity, effects on immune maturation and senescence. Brain Behavaviour and Immunity, 21(8), 1000–1008.CrossRefGoogle Scholar
  21. Cohen, M., Deamant, C., Barkan, S., Richardson, J., Young, M., Holman, S., et al. (2000). Domestic violence and childhood sexual abuse in HIV-infected women and women at risk for HIV. American Journal of Public Health, 90(4), 560–565.PubMedCrossRefGoogle Scholar
  22. Crosby, R. A., Wingood, G. M., DiClemente, R. J., & Rose, E. S. (2002). Family-related correlates of sexually transmitted disease and barriers to care: a pilot study of pregnant African American adolescents. Family and Community Health, 25(2), 16–27.PubMedCrossRefGoogle Scholar
  23. Downs, W. R. (1993). Developmental considerations for the effects of childhood sexual abuse [Special issue: Research on treatment of adults sexually abused in childhood]. Journal of Interpersonal Violence, 8(3), 331–345.CrossRefGoogle Scholar
  24. Draucker, C. B. (1997). Early family life and victimization in the lives of women. Research in Nursing &amp. Health, 20(5), 399–412.Google Scholar
  25. Fleming, D., & Wasserheit, J. (1999). From epidemiology synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75(1), 3–17.PubMedCrossRefGoogle Scholar
  26. Freshwater, K., Leach, C., & Aldridge, J. (2001). Personal constructs, childhood sexual abuse, and revictimization. The British Journal of Medical Psychology, 74, 379–397.CrossRefGoogle Scholar
  27. Friedman, M. J., Charney, D. S., & Deutch, A. Y. (1995). Neurobiological and clinical consequences of stress: from normal adaptation to post-traumatic stress disorder (p. 551). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
  28. Gibson, R. L., & Hartshorne, T. S. (1996). Childhood sexual abuse and adult loneliness and network orientation. Child Abuse and Neglect, 20(11), 1087–1093.PubMedCrossRefGoogle Scholar
  29. Gorcey, M., Santiago, J. M., & McCall-Perez, F. (1986). Psychological consequences for women sexually abused in childhood. Social Psychiatry, 21(3), 129–133.PubMedCrossRefGoogle Scholar
  30. Harlow, L. L., Rose, J. S., Morokoff, P. J., Quina, K., Mayer, K., Mitchell, K., et al. (1998). Women HIV sexual risk takers: related behaviors, issues and attitudes. Women’s Health: Research on Gender, Behavior, and Policy, 4, 407–439.Google Scholar
  31. Hays, R. B., McKusick, L., Pollack, L., Hilliard, R., Hoff, C., & Coates, T. J. (1993). Disclosing HIV seropositivity to significant others. AIDS, 7(3), 425–431.PubMedCrossRefGoogle Scholar
  32. Heim, C., Newport, D. J., Heit, S., Graham, Y. P., Wilcox, M., Bonsall, R., et al. (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in child-hood. JAMA: Journal of the American Medical Association, 284(18), 2321–2322.PubMedCrossRefGoogle Scholar
  33. Heise, L., Moore, K., & Toubia, N. (1995). Sexual coercion and reproductive health: A focus on research. New York: Ebert Program in Reproductive Health of the Population Council and the Health and Development Policy Project.Google Scholar
  34. Johnsen, L. W., & Harlow, L. L. (1996). Childhood sexual abuse linked with adult substance use, victimization, and AIDS risk. AIDS Education and Prevention, 8(1), 44–57.PubMedGoogle Scholar
  35. Kegeles, S. M., Rebchook, G. M., & Tebbetts, S. (2005). Challenges and facilitators to building program evaluation capacity among community-based organizations. AIDS Education and Prevention, 17(4), 284–299.PubMedCrossRefGoogle Scholar
  36. Kelly, B., Raphael, B., Burrows, G., Judd, F., Kernutt, G., Burnett, P., et al. (2000). Measuring psychological adjustment to HIV infection. International Journal of Psychiatry in Medicine, 30(1), 41–59.PubMedCrossRefGoogle Scholar
  37. Kerner, J., Rimer, B., & Emmons, K. (2005). Dissemination research and research dissemination: How can we close the gap? Health Psychology, 24(5), 443–446.PubMedCrossRefGoogle Scholar
  38. Kiecolt-Glaser, J. K., & Glaser, R. (1992). Stress and the immune system: Human studies. American Psychiatric Press Review of Psychiatry, 11, 169–180.Google Scholar
  39. Koopman, C., Gore-Felton, C., Classen, C., Kim, P., & Spiegel, D. (2001). Acute stress reactions to everyday stressful life events among sexual abuse survivors with PTSD. Journal of Child Sexual Abuse, 10(2), 83–99.PubMedCrossRefGoogle Scholar
  40. Kopnisky, K. L., Stoff, D. M., & Rausch, D. M. (2004). Workshop report: the effects of psychological variables on the progression of HIV-1 disease. Brain, Behavior, and Immunity, 18(3), 246–261.PubMedCrossRefGoogle Scholar
  41. Kumar, M., Kumar, A. M., Walididrop, D., Antoni, M. H., & Eisdorfer, C. (2003). HIV-1 infection and its impact on the HPA axis, cytokins, and cognition. Stress, 6(3), 167–172.PubMedCrossRefGoogle Scholar
  42. Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. JAMA: Journal of the American Medical Association, 281(6), 537–544.PubMedCrossRefGoogle Scholar
  43. Loeb, T., Williams, J. K., Carmona, J. V., Rivkin, I. D., Wyatt, G., Chin, D., et al. (2002a). Child sexual abuse associations with the sexual functioning of adolescents and adults. Annual Review of Sex Research, 13, 307–345.PubMedGoogle Scholar
  44. McCauley, J., Kern, D. E., Kolodner, K., Derogatis, L. R., & Bass, E. B. (1998). Relation of low-severity violence to women’s health. Journal of General Internal Medicine, 13(10), 687–691.PubMedCrossRefGoogle Scholar
  45. Minkler, M. (2005). Community-based research partnerships: Challenges and opportunities. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 82(Suppl. 2), ii3–ii12.Google Scholar
  46. Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health, 91(5), 753–760.PubMedCrossRefGoogle Scholar
  47. Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E., & Herbison, G. P. (1994). The effect of child sexual abuse on social, interpersonal and sexual function in adult life. The British Journal of Psychiatry, 165(1), 35–47.PubMedCrossRefGoogle Scholar
  48. Myers, H. F., Sumner, L. A., Ullman, B. J., Loeb, T. B., Carmona, J. V., & Wyatt, G. E. (2009). Trauma and psychosocial predictors of substance abuse in women impacted by HIV/AIDS. The Journal of Behavioral Health Services and Research, 36(2), 233–246.CrossRefGoogle Scholar
  49. Polusny, M. A., & Follette, V. M. (1995). Long-term correlates of child sexual abuse: theory and review of the empirical literature. Applied and Preventive Psychology, 4(3), 143–166.CrossRefGoogle Scholar
  50. Rasmusson, A. M., Vythilingam, M., & Morgan, C. A, III (2003). The neuroendocrinology of posttraumatic stress disorder: new directions. CNS Spectr, 8(9), 651-656, 665-657.PubMedGoogle Scholar
  51. Rebchook, G. M., Kegels, S. M., Huebner, D., & the TRIP Team. (2006). Transplanting research into practice: The dissemination and initial implementation of an evidence-based HIV prevention program. AIDS Education and Prevention, 18(Suppl. A), 119–136.PubMedCrossRefGoogle Scholar
  52. Schiffer, F., Teicher, M. H., Anderson, C., Tomoda, A., Polcari, A., Navalta, C. P., et al. (2007). Determination of hemispheric emotional valence in individual subjects: a new approach with research and therapeutic implications. Behavioral and brain functions: BBF, 3, 13.PubMedCrossRefGoogle Scholar
  53. Simoni, J. M., Mason, H. R. C., Marks, G., & Ruiz, M. S. (1995a). Women’s self-disclosure of HIV infection: Rates, reasons, and reactions. Journal of Consulting and Clinical Psychology, 63(3), 474–478.PubMedCrossRefGoogle Scholar
  54. Simoni, J. M., Mason, H. R. C., Marks, G., & Ruiz, M. S. (1995b). Women living with HIV: Sexual behaviors and counseling experiences. Women and Health, 23(4), 17–26.Google Scholar
  55. Simpson, T. L. (2002). Women’s treatment utilization and its relationship to childhood sexual abuse history and lifetime PTSD. Substance Abuse, 23(1), 17–30.PubMedGoogle Scholar
  56. Smith, G. (1992). The unbearable traumatogenic past: child sexual abuse. In V. P. Varma (Ed.), The secret life of vulnerable children (pp. 130–156). Florence: Taylor & Frances.Google Scholar
  57. Smith, D. W., Letourneau, E. J., Saunders, B. E., Kilpatrick, D. G., Resnick, H. S., & Best, C. L. (2000). Delay in disclosure of childhood rape: results from a national survey. Child Abuse and Neglect, 24(2), 273–287.PubMedCrossRefGoogle Scholar
  58. Stein, M. B., Koverola, C., Hanna, C., Torchia, M. G., & McClarty, B. (1997). Hippocampal volume in women victimized by childhood sexual abuse. Psychological Medicine, 27(4), 951–959.PubMedCrossRefGoogle Scholar
  59. Thompson, N. J., Potter, J. S., Sanderson, C. A., & Maibach, E. W. (1997). The relationship of sexual abuse and HIV risk behaviors among heterosexual adult female STD patients. Child Abuse and Neglect, 21(2), 149–156.PubMedCrossRefGoogle Scholar
  60. Urquiza, A. J., & Goodlin-Jones, B. L. (1994). Child sexual abuse and adult revictimization with women of color [Special issue: Violence against women of color]. Violence and Victims, 9(3), 223–232.PubMedGoogle Scholar
  61. Vogeltanz, N. D., Wilsnack, S. C., Harris, T. R., Wilsnack, R. W., Wonderlich, S. A., & Kristjanson, A. F. (1999). Prevalence and risk factors for childhood sexual abuse in women: national survey findings. Child Abuse and Neglect, 23(6), 579–592.PubMedCrossRefGoogle Scholar
  62. West, C. M., Williams, L. M., & Siegel, J. A. (2000). Adult sexual victimization among Black women sexually abused in childhood: a prospective examination of serious consequences of abuse [Special focus section: Repeat victimization]. Child Maltreatment: Journal of the American Professional Society on the Abuse of Children, 5(1), 49–57.Google Scholar
  63. Wingood, G. M., & DiClemente, R. (1997a). Child sexual abuse, HIV sexual risk, and gender relations of African-American women. American Journal of Preventive Medicine, 13(5), 380–384.PubMedGoogle Scholar
  64. Wingood, G., & DiClemente, R. (1997b). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 87(6), 1016–1018.PubMedCrossRefGoogle Scholar
  65. World Health Organization. (2002). World report on violence and health.
  66. Wyatt, G. E. (1985). The sexual abuse of Afro-American and White-American women in childhood. Child Abuse and Neglect, 9(4), 507–519.PubMedCrossRefGoogle Scholar
  67. Wyatt, G. E. (1992). The sociocultural context of African American and White American ­women’s rape. Journal of Social Issues, 48(1), 77–91.CrossRefGoogle Scholar
  68. Wyatt, G. E. (1994a). The sociocultural relevance of sex research: challenges for the 1990s and beyond. Paper presented at the 101st Annual Convention of the American Psychological Association, Toronto, Canada.Google Scholar
  69. Wyatt, G. E. (1994b). The sociocultural relevance of sex research: Challenges for the 1990s and beyond. The American Psychologist, 49(8), 748–754.PubMedCrossRefGoogle Scholar
  70. Wyatt, G. E. (1997). Stolen women: reclaiming our sexuality, taking back our lives. New York: Wiley.Google Scholar
  71. Wyatt, G. E. (2009). Enhancing cultural and contextual intervention strategies to reduce HIV/AIDS among African Americans. American Journal of Public Health, 99(11), 1941–1945.Google Scholar
  72. Wyatt, G. E., & Riederle, M. (1994a). Sexual harassment and prior sexual trauma among African-American and White American women [Special issue: Violence against women of color]. Violence and Victims, 9(3), 233–247.PubMedGoogle Scholar
  73. Wyatt, G. E., & Riederle, M. H. (1994b). Reconceptualizing issues that affect women’s sexual decision-making and sexual functioning [Special issue: Transformations: reconceptualizing theory and research with women]. Psychology of Women Quarterly, 18(4), 611–625.CrossRefGoogle Scholar
  74. Wyatt, G. E., Axelrod, J., Chin, D., Carmona, J. V., & Loeb, T. B. (2000). Examining Patterns of Vulnerability to Domestic Violence Among African American Women. Paper presented at the African American Institute on Domestic Violence in the Community, St Paul, MN, US.Google Scholar
  75. Wyatt, G. E., Carmona, J. V., Loeb, T. B., Ayala, A., & Chin, D. (2002). Sexual abuse. In G. M. Wingood & R. J. DiClemente (Eds.), Handbook of women’s sexual and reproductive health. Issues in women health (pp. 195–216). New York: Kluwer Academic.CrossRefGoogle Scholar
  76. Wyatt, G. E., Carmona, J. V., Loeb, T. B., & Williams, J. K. (2005). HIV-positive black women with histories of childhood sexual abuse: patterns of substance use and barriers to health care. Journal of Health Care for the Poor and Underserved, 16(4 Suppl. B), 9–23.PubMedGoogle Scholar
  77. Wyatt, G. E., Guthrie, D., & Notgrass, C. M. (1992). Differential effects of women’s child sexual abuse and subsequent sexual revictimization. Journal of Consulting and Clinical Psychology, 60(2), 167–173.PubMedCrossRefGoogle Scholar
  78. Wyatt, G. E., Longshore, D., Chin, D., Carmona, J. V., Loeb, T. B., Myers, H. F., et al. (2004). The efficacy of an integrated risk reduction intervention for HIV-positive women with child sexual abuse histories. AIDS and Behavior, 8(4), 453–462.PubMedCrossRefGoogle Scholar
  79. Wyatt, G. E., Myers, H. F., Williams, J. K., Kitchen, C. R., Loeb, T., Carmona, J. V., et al. (2002). Does a history of trauma contribute to HIV risk for women of color? Implications for prevention and policy. American Journal of Public Health, 92(4), 660–665.PubMedCrossRefGoogle Scholar
  80. Wyatt, G. E., Newcomb, M. D., & Riederle, M. H. (1993). Sexual abuse and consensual sex: women’s developmental patterns and outcomes. Thousand Oaks: Sage.Google Scholar
  81. Wyatt, G., Notgrass, C. M., & Gordon, G. (1995). The effects of African American women’s sexual revictimization: Strategies for prevention. In C. Swift (Ed.), Sexual assault and abuse: sociocultural context of prevention (pp. 111–134). New York: Haworth.Google Scholar
  82. Wyatt, G., Tucker, B., Romero, G. J., Vargas-Carmona, J., Newcomb, M. D., Wayment, H. A., et al. (1997). Adapting a comprehensive approach to African-American women’s sexual risk taking. Journal of Health Education, 28(Suppl. 6), S52–S60.Google Scholar
  83. Zlotnick, C., Mattia, J., & Zimmerman, M. (2001). Clinical features of survivors of sexual abuse with major depression. Child Abuse and Neglect, 25(3), 357–367.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Lekeisha A. Sumner
    • 1
  • Gail E. Wyatt
  • Dorie Glover
  • Jennifer V. Carmona
  • Tamra B. Loeb
  • Tina B. Henderson
  • Dorothy Chin
  • Rotrease S. Regan
  1. 1.Department of Psychiatry and Biobehavioral SciencesUCLALos AngelesUSA

Personalised recommendations