United Press International - Wednesday, January 13, 1999

Researchers report today that among inner city black women, those infected with HIV were two to five times more likely to have been victims of violence than uninfected females. The study, led by researchers at the University of California-San Francisco appears in the winter issue of the Journal of Traumatic Stress.

"Among women we talked to who were infected with HIV, those who had experienced victimization also reported more psychological distress, depression, and more physical symptoms," Dr. Rachel Kimerling of the University of California-San Francisco told United Press International.

The study team investigated 88 HIV-infected women, and a comparison group of 148 uninfected women, all black with similar backgrounds. Two- thirds of the HIV-infected group reported having experienced extreme forms of violent victimization, Kimerling said.

"These results underscore the importance of acknowledging the experience of violent victimization in the prevention and treatment of HIV infection in women," Kimerling said. "A woman who is being physically battered by her male partner fears abuse consequences if she refuses sexual activity, or if she queries her partner about his sexual behavior, so there is this logical link that having been victimized might increase your risk of HIV."

Primary care and public health physicians need to recognize that previous victimization "puts you at a greater risk for HIV, but we don't know exactly why," she said.

"Women who've been assaulted or abused are more likely to engage in a number of behaviors that can increase their risk for HIV infection. Among these are substance abuse, sex in exchange for drugs or money, and increased likelihood of unprotected sexual encounters."

AIDS prevention programs should take this into and counsel such people more emphatically on ways to protect themselves, Kimerling said. She said that even if HIV programs "teach safe sex skills, women may be less able to put those skills into action if suffering from PTSD."

The rising incidence of HIV infection among inner-city, low-income blacks appears to be closely linked to environmental and cultural factors, such as drugs, crime, poverty and gender and racial discrimination, the researchers said. An HIV-infected woman's ability to "hold her own" in such an environment seems to be further impaired by depression, they said.

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