Child sexual abuse, alcohol and drug (mis)use, and human immunodeficiency virus (HIV) vulnerability among African-American women: An exploratory study.

This dissertation explored the relationship between child sexual abuse (CSA), alcohol and drug (mis)use, and human immunodeficiency virus (HIV) vulnerability among African American women seeking substance abuse treatment. Differences in (1) alcohol and drug (mis)use, (2) behavior which increased potential for HIV infection, and (3) readiness to change behavior related to alcohol and drug (mis)use were examined among women with (N = 55) and without a history (N = 79) of child sexual abuse. Study participants included 135 African American women at six residential substance abuse treatment sites in Wayne County who completed a pre-HIV Intervention Program survey conducted by the Health department. In addition, a subsample of seven women were interviewed in-depth to investigate the effects of CSA history and traumatic life events on the three dependent variables--substance (mis)use, readiness to change, and HIV vulnerability. Multivariate analyses did not support a relationship between CSA history and alcohol and drug (mis)use, readiness to change, and HIV vulnerability. However, other analyses did find differences between the abused and non-abused women on the following variables: (1) demographics characteristics, (2) readiness to change subscales, and (3) condom use and sexual habits with a casual partner. The content analysis and timeline construction based on the individual interviews also did not support a relationship between CSA history and the various dependent variables. Rather, trauma (as defined by violent and non-violent life events), and stressful and difficult life circumstances was a common theme for both abused and non-abused women. Overall, these results suggest that for women with and without a history of CSA seeking substance abuse treatment, trauma may be more important than CSA history to understanding the progression of alcohol and drug (mis)use among this group of women. The use of timelines and social history interviewing may serve to illucidate the connection between various stressors and traumatic life events and alcohol and drug (mis)use with important implications for substance abuse treatment planning. In order to develop more effective substance abuse treatment for women, future research in the area of women and alcohol and drug (mis)use should examine the role of various types of trauma in the etiology and progression of women's alcohol and drug (mis)use.Ph.D.Ethnic studiesPsychologySocial SciencesSocial psychologySocial workWomen's studiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/130096/2/9712063.pd