Description
The purpose of this study was to examine relationships between exposure to trauma (i.e., lifetime sexual abuse and past-year emotional abuse, physical and sexual abuse) among women living with HIV/AIDS's (WLWHA) and their ability to attend their HIV medical appointments in the past six months. This study utilized a cross-sectional design with secondary data from 105 WLWHA who were living in San Diego County and participated in the Coordinated HIV Assistance and Navigation for Growth and Empowerment for Women (CHANGE for Women) program at Christie's Place through 2014. Almost half (47.6%) of the women in the sample reported missing an HIV-related medical appointment in the past six months. Exposure to trauma was also frequent in this sample (lifetime sexual abuse=42.9%, any past-year emotional, physical, or sexual abuse=24.8%). Bivariate analyses revealed that women who reported lifetime sexual abuse and past-year emotional or physical abuse were more likely to miss a medical appointment than women who reported not experiencing these types of traumas (p-values<.05). Compared to women who reported no past-year trauma (30.8%) missed a medical appointment), women who reported any pastyear trauma (69.2%, p=.011) or two or more types of traumas (88.9%, p=.011) were more likely to miss a medical appointment. Multivariable logistic regression models adjusting for confounding by race/ethnicity, age, educational level, employment status, and insurance status did not reveal statistically significant associations between lifetime sexual abuse (Adjusted Odds Ratio [AOR]: 1.03; 95% Confidence Interval [CI]: 0.34, 3.13) or any pastyear trauma (AOR: 2.09; 95% CI: 0.73, 6.00) and missed visits. However, women exposed to two or more types of past-year traumas were more likely than women not exposed to these traumas to miss a medical appointment (AOR: 9.54; 95% CI: 1.01, 89.8). This study suggests that exposure to recent and multiple types of trauma may play an important role in medical appointment adherence. This study also suggests that women with these trauma experiences may need additional support to attend their medical appointments. Understanding genderspecific barriers to care that WLWHA experience can help inform interventions that the medical and social service community can develop to facilitate retention in HIV care.
