Recent Sexual Violence Exposure is Associated with Immune Biomarkers of HIV Susceptibility in Women

The biobehavioral impacts of sexual violence: Findings from an acute repeat survivor of vaginal rape

Women s Health ◽

10.1177/17455065211031079 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110310

Author(s):

Katherine M Anderson ◽

Mimi Ghosh ◽

Maile Y Karris ◽

Eleanor Capozzi ◽

Douglas A Granger ◽

...

Keyword(s):

Mental Health ◽

Sexual Violence ◽

Sexual Trauma ◽

Study Participant ◽

Hypothalamic Pituitary Adrenal Axis ◽

Hypothalamic Pituitary Adrenal ◽

Violence Victimization ◽

Adrenal Axis ◽

Immune Biomarkers ◽

Pituitary Adrenal Axis

Background: Individuals who have experienced repeat sexual violence victimization face adverse mental and physical health outcomes, including immune and stress response functioning. We aim to further understand repeat sexual violence victimization to develop responsive and appropriate treatment for survivors of sexual violence. Methods: We present the immunological and contextual findings of a participant ( N = 1) who experienced repeat sexual violence victimization during her enrollment in The THRIVE Study, a prospective case–control study of women aged 14–45 years, who have experienced recent consensual vaginal penetration (“controls”) or forced vaginal penetration (“cases”). Participants complete a survey, HIV/sexually transmitted infection, and pregnancy testing, blood sampling for C-reactive protein and adrenocorticotrophic hormone, collection of cervicovaginal fluid for immunological biomarkers, and self-collection of saliva samples for cortisol measurements, across study visits (Baseline, 1, and 3 months). Results: The case study participant, aged 18 years upon enrollment, experienced sexual trauma before four of five study visits. Trends in the mental health indicators demonstrate reciprocal fluctuations in adverse mental health and resilience in accordance with revictimization and circumstantial changes. Suppressed immune biomarkers appear to correlate with increased adverse mental health, while mental health recovery trends with immunological recovery. The participant presents with dysregulated hypothalamic–pituitary–adrenal axis diurnal profile. Conclusions: This profile illustrates the intra-individual biobehavioral impact of experience with revictimization over the course of 6 months, capturing experiences that are rarely studied either longitudinally or with the depth of the current research. The findings underscore the value of monitoring cervicovaginal immune functioning and hypothalamic–pituitary–adrenal axis dysregulation in coordination with changes in mental health over the course of repeated sexual trauma.

Download Full-text

The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo

Global Mental Health ◽

10.1017/gmh.2016.31 ◽

2017 ◽

Vol 4 ◽

Cited By ~ 9

Author(s):

L. Stark ◽

K. Asghar ◽

S. Meyer ◽

G. Yu ◽

T. Bakemore ◽

...

Keyword(s):

Sexual Violence ◽

Partner Violence ◽

Violence Exposure ◽

Democratic Republic ◽

Physical Violence ◽

Future Orientation ◽

Gender Norms ◽

Exposure To Violence ◽

Cross Sectional ◽

Republic Of The Congo

Background.Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls’ hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced girls.Methods.Secondary analysis, using multivariable regression of cross-sectional data from girls ages 10–14 in South Kivu, Democratic Republic of the Congo. Key variables of interest were attitudes toward intimate partner violence (IPV), Children's Hope Scale (CHS) score, and exposure to physical, emotional, and sexual violence within the last 12 months. Additional covariates included age, educational status, and territory.Results.The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for physical violence (β = −0.09, p = 0.040) and unwanted sexual touching (β = −0.20, p = 0.003) among girls age 10–14, when adjusting for other covariates. The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for forced sex (β = −0.22, p = 0.016) among girls age 13–14, when adjusting for covariates. Findings for emotional violence, any form of sexual violence, and coerced sex trended toward lower CHS scores for girls who reported higher acceptance of IPV, but did not reach significance.Conclusions.Findings support the utility of gender norms-transformative programming in increasing resilience of girls who have experienced sexual violence in humanitarian contexts.

Download Full-text

Sexual Violence Victimization Among Youth Presenting to an Urban Emergency Department: The Role of Violence Exposure in Predicting Risk

Health Education & Behavior ◽

10.1177/1090198117741941 ◽

2017 ◽

Vol 45 (4) ◽

pp. 625-634 ◽

Cited By ~ 1

Author(s):

Andria B. Eisman ◽

Quyen M. Ngo ◽

Yasamin Y. Kusunoki ◽

Erin E. Bonar ◽

Marc A. Zimmerman ◽

...

Keyword(s):

Emergency Department ◽

Sexual Violence ◽

Parent Education ◽

Violence Exposure ◽

Specific Content ◽

Disadvantaged Communities ◽

Peer Violence ◽

Forms Of Violence ◽

Urban Emergency Department

Sexual violence (SV) is a widespread public health problem among adolescents and emerging adults with significant short- and long-term consequences. Young people living in urban, disadvantaged communities with high rates of violence may be especially at risk for SV victimization. Understanding interconnections between different forms of violence is critical to reducing SV risk among youth. Participants were youth ( N = 599) ages 14 to 24 years ( M = 20.05, SD = 2.42) presenting to an urban emergency department with a Level 1 trauma designation as part of a prospective cohort study and followed-up for 24 months. We used logistic regression to examine the probability of reporting SV during the 24-month follow-up based on baseline reports of community and peer violence exposure, accounting for previous SV victimization, substance use, and sociodemographic characteristics. Among youth presenting to an urban emergency department, 22% of youth not seeking care for a sexual assault reported any lifetime SV (forced and/or substance-induced sexual intercourse) at baseline. During the 24-month follow-up, 12% reported SV victimization. We found high community violence exposure (odds ratio [OR] = 2.96, 95% confidence interval [CI] [1.01, 8.68]) and peer violence exposure (OR = 1.58, 95% CI [1.19, 2.08]) were associated with increased odds of reporting SV during follow-up in addition to previous SV victimization (OR = 2.71, 95% CI [1.45, 5.09]). Sex, age, parent education, and alcohol or other drug use at baseline were not associated with odds of SV during follow-up. Investigating interconnections between SV victimization and other forms of violence across socioecological levels provides an opportunity to advance SV research and identify promising avenues for prevention based on other violence prevention research. Future strategies for SV prevention that incorporate community and peer components as well as SV-specific content may help reduce SV victimization among youth living in urban, disadvantaged communities.

Download Full-text

The Role of Stress and Genital Immunity in Sexual Trauma and HIV Susceptibility Among Adolescent Girls and Adult Women (The THRIVE Study): Protocol for a Longitudinal Case-Control Study (Preprint)

10.2196/preprints.18190 ◽

2020 ◽

Author(s):

Jamila K Stockman ◽

Katherine M Anderson ◽

Maile Y Karris ◽

Constance A Benson ◽

Kiyomi Tsuyuki ◽

...

Keyword(s):

Sexual Violence ◽

Adolescent Girls ◽

Sexual Trauma ◽

Case Control Study ◽

Case Control ◽

Adult Women ◽

Hiv Susceptibility ◽

The Past ◽

Anti Hiv ◽

Control Study

BACKGROUND The relationship between sexual violence and HIV risk has been extensively documented through social and behavioral research; however, the underlying biological mechanisms are poorly understood. OBJECTIVE The purpose of the THRIVE (Trauma and HIV Risk: Investigating Stress and the Immune Disruption of the Vaginal Environment) Study is to examine the impact of sexual trauma due to sexual violence on HIV susceptibility through dysregulation of soluble inflammatory and anti-inflammatory and anti-HIV biomarkers in the female genital tract and dysregulation of the hypothalamic-pituitary-adrenal axis among adolescent girls and adult women. METHODS The THRIVE Study is a longitudinal case-control study conducted in San Diego, CA, among a racially diverse sample. Cases are adolescent girls (aged 14-19 years) or adult women (aged 20-45 years) who have experienced forced vaginal penetration by a phallus perpetrated by a man within the past 15 days. Controls are adolescent girls or adult women who have engaged in consensual vaginal sex with a man within the past 15 days. At baseline and 1- and 3-month follow-up study visits, participants undergo a urine-based pregnancy test; venipuncture blood draw for HIV, C-reactive protein, adrenocorticotropic hormone, and progesterone testing; a 45-min interviewer-administered computer survey; and cervicovaginal lavage to measure proinflammatory and anti-inflammatory and anti-HIV soluble immune biomarkers. After each study visit, participants self-collect saliva specimens (upon waking, 30 min after waking, and 45 min after waking) at home for 3 consecutive days, which are later assayed for cortisol and dehydroepiandrosterone sulfate. Participants receive compensation at each study visit and for the return of saliva specimens, and a list of local medical and support services. Study procedures use trauma-informed care methods, given the sensitive nature of the study and enrollment of women in the acute phase after sexual trauma. All research staff and investigators adhere to ethical principles and guidelines in the conduct of research activities. Data will be analyzed for descriptive and inferential analyses. RESULTS The recruitment of participants is ongoing. The publication of the first results is expected by late 2021. CONCLUSIONS The THRIVE Study will provide foundational knowledge on how sexual trauma due to sexual violence increases susceptibility to HIV acquisition via alterations in cervicovaginal immune regulation and the psychobiology of the stress responses. These findings will inform future research on mechanistic models of in vitro and in vivo injury and cervicovaginal wound healing processes, which may lead to the development of nonvaccine biomedical HIV prevention products for girls and women. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18190

Download Full-text

Associations Between Interpersonal Violence, Psychological Distress, and Suicidal Ideation Among Formerly Incarcerated Men and Women

Journal of Interpersonal Violence ◽

10.1177/0886260520933045 ◽

2020 ◽

pp. 088626052093304

Author(s):

Madeleine Newman ◽

Lisa Fedina ◽

Boyoung Nam ◽

Jordan DeVylder ◽

Binta Alleyne-Green

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Suicidal Ideation ◽

Sexual Violence ◽

Interpersonal Violence ◽

Violence Exposure ◽

Mental Health Symptoms ◽

Formerly Incarcerated ◽

Health Symptoms ◽

Incarcerated Men

Survivors of interpersonal violence are at increased risk of negative mental health outcomes; however, scant research has explored the relationship between violence exposure and mental health symptoms among formerly incarcerated individuals. This cross-sectional survey study investigates the demographic characteristics and mental health symptoms (i.e., psychological distress and suicidal ideation) associated with interpersonal violence exposure, including physical and sexual intimate partner violence, non-partner sexual violence, and sexual violence perpetrated by prison employees in a sample of formerly incarcerated men and women, with the aim that the findings both deepen the understanding of the effects of sexual violence exposure and help inform prison and jail policies. Surveys were administered to English-speaking adults ages 18 and older to recruit a sample of adults who were formerly incarcerated ( N = 201). Questions on the survey included questions regarding demographic details, sexual violence exposure, mental health symptoms, and time incarcerated. Findings show that higher levels of sexual violence exposure were significantly associated with higher levels of psychological distress and reporting of suicidal ideation. Results also suggest that higher levels of income and education and younger age were significantly associated with sexual violence perpetrated by prison employees. In addition, most forms of interpersonal violence were independently associated with psychological distress and suicidal ideation in this population. The findings make recommendations for prison and jail policies to include targeted treatment for individuals with sexual victimization histories, to mitigate the risk of revictimization and appropriately treat adverse mental health outcomes from sexual victimization within and outside the confines of incarceration.

Download Full-text

The Role of Stress and Genital Immunity in Sexual Trauma and HIV Susceptibility Among Adolescent Girls and Adult Women (The THRIVE Study): Protocol for a Longitudinal Case-Control Study

JMIR Research Protocols ◽

10.2196/18190 ◽

2020 ◽

Vol 9 (12) ◽

pp. e18190

Author(s):

Jamila K Stockman ◽

Katherine M Anderson ◽

Maile Y Karris ◽

Constance A Benson ◽

Kiyomi Tsuyuki ◽

...

Keyword(s):

Sexual Violence ◽

Adolescent Girls ◽

Sexual Trauma ◽

Case Control Study ◽

Case Control ◽

Adult Women ◽

Hiv Susceptibility ◽

The Past ◽

Anti Hiv ◽

Control Study

Background The relationship between sexual violence and HIV risk has been extensively documented through social and behavioral research; however, the underlying biological mechanisms are poorly understood. Objective The purpose of the THRIVE (Trauma and HIV Risk: Investigating Stress and the Immune Disruption of the Vaginal Environment) Study is to examine the impact of sexual trauma due to sexual violence on HIV susceptibility through dysregulation of soluble inflammatory and anti-inflammatory and anti-HIV biomarkers in the female genital tract and dysregulation of the hypothalamic-pituitary-adrenal axis among adolescent girls and adult women. Methods The THRIVE Study is a longitudinal case-control study conducted in San Diego, CA, among a racially diverse sample. Cases are adolescent girls (aged 14-19 years) or adult women (aged 20-45 years) who have experienced forced vaginal penetration by a phallus perpetrated by a man within the past 15 days. Controls are adolescent girls or adult women who have engaged in consensual vaginal sex with a man within the past 15 days. At baseline and 1- and 3-month follow-up study visits, participants undergo a urine-based pregnancy test; venipuncture blood draw for HIV, C-reactive protein, adrenocorticotropic hormone, and progesterone testing; a 45-min interviewer-administered computer survey; and cervicovaginal lavage to measure proinflammatory and anti-inflammatory and anti-HIV soluble immune biomarkers. After each study visit, participants self-collect saliva specimens (upon waking, 30 min after waking, and 45 min after waking) at home for 3 consecutive days, which are later assayed for cortisol and dehydroepiandrosterone sulfate. Participants receive compensation at each study visit and for the return of saliva specimens, and a list of local medical and support services. Study procedures use trauma-informed care methods, given the sensitive nature of the study and enrollment of women in the acute phase after sexual trauma. All research staff and investigators adhere to ethical principles and guidelines in the conduct of research activities. Data will be analyzed for descriptive and inferential analyses. Results The recruitment of participants is ongoing. The publication of the first results is expected by late 2021. Conclusions The THRIVE Study will provide foundational knowledge on how sexual trauma due to sexual violence increases susceptibility to HIV acquisition via alterations in cervicovaginal immune regulation and the psychobiology of the stress responses. These findings will inform future research on mechanistic models of in vitro and in vivo injury and cervicovaginal wound healing processes, which may lead to the development of nonvaccine biomedical HIV prevention products for girls and women. International Registered Report Identifier (IRRID) DERR1-10.2196/18190

Download Full-text

Mechanisms Underlying Sexual Violence Exposure and Psychosocial Sequelae: A Theoretical and Empirical Review

Clinical Psychology Science and Practice ◽

10.1111/cpsp.12004 ◽

2012 ◽

Vol 19 (3) ◽

pp. 260-275 ◽

Cited By ~ 36

Author(s):

Kate Walsh ◽

Sandro Galea ◽

Karestan C. Koenen

Keyword(s):

Sexual Violence ◽

Violence Exposure ◽

Psychosocial Sequelae

Download Full-text

What determines violent behavior in men? Predicting physical, psychological and sexual violent offending based on classification and regression tree analysis.

10.31234/osf.io/kcg6z ◽

2020 ◽

Author(s):

Delia Vanessa Leiding ◽

Franziska Kaiser ◽

Marion Steffens ◽

Andrei A. Puiu ◽

Ute Habel

Keyword(s):

Drug Use ◽

Sexual Violence ◽

Violence Exposure ◽

Physical Violence ◽

Regression Tree ◽

Exposure To Violence ◽

Tree Analysis ◽

Prevention And Intervention ◽

Regression Tree Analysis ◽

Violent Offending

Despite compelling evidence that victimization and offending co-occur, it remains unclear what types of victimization are linked to specific forms of perpetration. Here we examined the relationship between physical, psychological, and sexual violence with respect to influencing variables including mental health, risk-taking behaviors, and coping strategies. Data from 5,385 men were collected as part of an epidemiological study on violence experience. A classi-fication and regression tree analysis identified the main predictors of violence perpetration and classified violent offending into high- and low risk groups. Results indicate that violence is best predicted by previous exposure to violence and polyvictimization. Physical violence is best predicted by prior exposure to physical violence and this is further influenced by the fre-quency of and the age at which violence was experienced. Drug use was a strong predictor of physical and psychological violence. The latter is best predicted by a history of polyvictimiza-tion, the severity and the originator of violence. Sexual violence is strongly predicted by one´s sexual violence experience. Other factors such as demographic characteristics are less predic-tive. Our results may contribute to the development of early prevention and intervention ap-proaches that account for different risk factors. The significance of violence exposure suggest that intervention measures must focus on victims of early and prolonged experience of vio-lence. On the strength of the link between drug use and violence, exposure to violence should be considered in drug prevention and intervention and vice versa.

Download Full-text