A Sexual Risk and Stress Reduction Intervention Designed for HIV-Positive Bisexual African American Men with Childhood Sexual Abuse Histories
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OBJECTIVES: HIV transmission risk is high among men who have sex with men and women (MSMW), and it is further heightened by a history of childhood sexual abuse (CSA) and current traumatic stress or depression. Yet, traumatic stress is rarely addressed in HIV interventions. We tested a stress-focused sexual risk reduction intervention for African American MSMW with CSA histories. METHODS: This randomized controlled trial compared a stress-focused sexual risk reduction intervention with a general health promotion intervention. Sexual risk behaviors, psychological symptoms, stress biomarkers (urinary cortisol and catecholamines), and neopterin (an indicator of HIV progression) were assessed at baseline and at 3- and 6-month follow-ups. RESULTS: Both interventions decreased and sustained reductions in sexual risk and psychological symptoms. The stress-focused intervention was more efficacious than the general health promotion intervention in decreasing unprotected anal insertive sex and reducing depression symptoms. Despite randomization, baseline group differences in CSA severity, psychological symptoms, and biomarkers were found and linked to subsequent intervention outcomes. CONCLUSIONS: Although interventions designed specifically for HIV-positive African American MSMW can lead to improvements in health outcomes, future research is needed to examine factors that influence intervention effects.
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HIV transmission risk is notably high among men who have sex with men and women, especially those with histories of childhood sexual abuse and current traumatic stress or depression.
“For instance, HIV transmission risk is notably high among men who have sex with men and women (MSMW), especially those with histories of childhood sexual abuse and current traumatic stress or depression.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
Stress mediators interact with the dopaminergic reward system and other systems involved in addiction, such as endogenous opioids, the SAM system, and endocannabinoids.
“Stress mediators interact with the dopaminergic reward system and other systems involved in addiction, such as endogenous opioids, the SAM system, and endocannabinoids.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
BSRPs have been shown to be more effective than general health promotion interventions in reducing risky sexual behaviors and depression symptoms in MSMW with histories of childhood sexual abuse and current traumatic stress or depression.
“BSRPs have been shown to be more effective than general health promotion interventions in reducing risky sexual behaviors and depression symptoms in this population.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
Emerging research highlights the role of stress in behavioral addictions, including hypersexual behavior, gambling, dysfunctional internet use, and food addiction.
“Emerging research highlights the role of stress in behavioral addictions, including hypersexual behavior, gambling, dysfunctional internet use, and food addiction.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
Stress and the neurobiology of the stress response play critical roles in substance use initiation, maintenance, and relapse.
“Stress and the neurobiology of the stress response play critical roles in substance use initiation, maintenance, and relapse.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
Stress during adolescence can increase sensitivity to drugs of abuse and alter the final maturation of cortical dopamine, potentially through mechanisms involving D2 dopamine receptor regulation and glucocorticoid-facilitated pruning of dopamine fibers.
“Stress during adolescence can increase sensitivity to drugs of abuse and alter the final maturation of cortical dopamine, potentially through mechanisms involving D2 dopamine receptor regulation and the glucocorticoid-facilitated pruning of dopamine fibers [83,84,85].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
Adolescence is a critical period for the maturation of behavior, dopamine systems, and the HPA axis.
“Additionally, adolescence is a critical period for the maturation of behavior, dopamine systems, and the HPA axis.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [85]
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- Authors
- Williams, J. K., Glover, D. A., Wyatt, G. E., Kisler, K., Liu, H., & Zhang, M.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2013-08
- Volume
- 103
- Issue
- 8
- Pages
- 1476-1484
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC4007873
- OpenAlex
- W2074026975
- Cited by
- 57
- References
- 85
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 6 · 2013: 1
- FWCI
- 3.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (P50MH073453, R34MH077550)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- HIV, bisexual men, African American men, child sexual abuse, traumatic stress, sexual risk reduction, unprotected anal intercourse, depression, urinary cortisol, catecholamines, neopterin, HIV disease progression, men who have sex with men and women, intervention efficacy
- MeSH terms
- Analysis of Variance, Bisexuality, Black or African American, Catecholamines, Health Promotion, Humans, Hydrocortisone, Male, Middle Aged, Surveys and Questionnaires, Sexual Behavior, Stress Disorders, Post-Traumatic, Biomarkers, HIV Infections, Chi-Square Distribution, Neopterin, Risk Reduction Behavior, Adult Survivors of Child Abuse
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