Document Type



Doctor of Philosophy (PhD)


Public Health

First Advisor's Name

Jessy G. Devieux

First Advisor's Committee Title

Committee Chair

Second Advisor's Name

H. Virginia McCoy

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Elena Bastida

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Maria Elena Villar

Fourth Advisor's Committee Title

Committee Member


childhood sexual abuse, childhood trauma, Haitian, women, risk factors, social support, alcohol use, sexual risk behaviors, relationship control, partner imbalance, perceived social support, susceptibility to violence, sexual self-efficacy, HIV-related risk factors, gender, theory of gender and power

Date of Defense



Childhood sexual abuse (CSA) is one of the least studied HIV-related risk factors in Haiti although research in the United States and Europe has clearly established the link between childhood trauma and HIV risk behaviors. Understanding the role and impact of CSA on HIV-positive Haitian women is likely to strengthen future HIV prevention and treatment efforts aimed at this vulnerable group.

The current study was a cross-sectional examination of baseline data collected during a randomized trial of a cognitive-behavioral stress management (CBSM) intervention in Haiti. The purpose of this study was to analyze the association between CSA and sexual risk behaviors, alcohol use, and social support in a group of Haitian women, ages 17-55 (n=229), who are HIV-positive alcohol users living in Haiti. The outcomes investigated were the respondents’ level of exposure to CSA and their current HIV-related risk factors. The Theory of Gender and Power provided the theoretical framework for variable selection and associative exploration. Statistical tests included descriptive analyses, chi-square tests, analysis of variance (ANOVA), and correlations.

Results showed that women who were exposed to some level of sexual abuse during childhood had less favorable attitudes towards condom use than women who reported no exposure to sexual abuse during childhood [F(2, 217) = 5.10, p = .007]. There were no differences between exposure groups for the remaining sexual risk behaviors: multiple partners, knowledge of HIV, and sexual self-efficacy. Women who were exposed to CSA also reported higher levels of alcohol use than reported by the women in the non-exposure group. Finally, there were no differences between exposure groups for social support.

Group differences in attitudes towards condom use and levels of alcohol use among HIV-positive Haitian women demonstrate that HIV-positive individuals have different past and present experiences that affect their current beliefs and behaviors. Examining women at the beginning of their diagnosis for childhood trauma and providing targeted interventions for coping with that trauma presents a valuable research opportunity. The findings of the current study suggest that more research is required to understand the association between CSA and HIV-related risk factors in this subset of the HIV-positive population.





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