The Impact of Childhood Household Violence on HIV-Related Outcomes in People With HIV in the United States: The Role of Psychological Distress and Social Stressors

作者：Phillip W. Schnarrs, Paul Nash, Stephanie A. Ruderman, Heidi M. Crane, Joseph A. Delaney, Mekialyla Singleton, Armin A. Dorri, Bridget M. Whitney, Rob J. Fredericksen, Cristina M. López, Greer Burkholder, Mari M. Kitahata, Richard D. Moore, Barbara Gripshover, Maile Karris, Meredith Greene, Conall O’Cleirigh, Claire E. Farel, Kenneth H. Mayer, Amanda L. Willig, Michael S. Saag, Allison R. Webel · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2025 · DOI：10.1097/qai.0000000000003772 · 被引用次数：1 · 研究领域：HIV/AIDS Research and Interventions、Intimate Partner and Family Violence、Adolescent Sexual and Reproductive Health

BACKGROUND: Psychological distress (eg, depression) and social stressors (eg, HIV-related stigma) can affect HIV-related outcomes such as antiretroviral therapy adherence and health-related quality of life (HRQL). Limited research on adverse childhood experiences such as childhood household violence (CHV) has shown a similar impact on HIV-related outcomes, particularly virologic suppression, although little is known about mediating pathways with factors such as psychological distress and social stressors. SETTING: Data from the Centers for AIDS Research Network of Integrated Clinical Systems cohort were analyzed. This article examines the relationship between CHV and HIV-related outcomes, and potential differences between those with and without CHV by age (<50 vs. ≥50 years). METHODS: Bivariate comparisons, linear regressions, and mediation analyses between CHV and other variables were used to assess association with outcome measures. RESULTS: Among 7705 people with HIV, CHV was reported by 19% (n = 1498). CHV was associated with lower antiretroviral therapy adherence (P < 0.001), more HIV symptoms (P < 0.001), and lower HRQL (P < 0.001). In addition, CHV exposure was associated with worse depressive symptoms (P < 0.001), increased panic symptoms (P < 0.001), lower social support (P < 0.001), greater self-report of HIV stigma (P < 0.001), and more exposure to intimate partner violence (P < 0.001). Psychological distress and social stressors mediated the relationship between C...