The CHASE study primarily sought to describe the psychosocial characteristics (mental health, substance use, traumatic event history, coping strategies, and social support) of individuals receiving HIV care and to examine the relationships between psychosocial characteristics and health outcomes. Published results from the CHASE study document a high prevalence of childhood (33%) and lifetime (50%) sexual abuse and severe physical abuse and identify associations between history of traumatic events and a range of negative health outcomes (worse overall health, higher health care utilization, higher sexual transmission risk behaviors, lower antiretroviral therapy [ART] adherence, more opportunistic infections [OIs], and higher all-cause and AIDS-related mortality).
Beyond their history of traumatic events, a large majority of CHASE participants experienced incident stressful and traumatic events during the 27 month follow-up period including death of a family member (41%) or close friend (37%), a serious non-HIV related illness, injury, or accident (54%), or sexual (1%) or physical (15%) assault. While a high burden of past traumatic events is well documented among HIV+ persons, few longitudinal studies have explored in depth the characteristics of those experiencing incident stressful and traumatic events after HIV infection or the health consequences of incident stressful and traumatic events.
This R03 is a secondary data analysis using existing data from the Coping with HIV/AIDS in the Southeast (CHASE) study to investigate the effects of incident stressful and traumatic events on health outcomes in HIV+ individuals.
The proposed secondary data analysis seeks to fill this knowledge gap by addressing three specific aims with the existing CHASE data:
(1) Describe the incidence of stressful and traumatic events, predictors of incident events, and differences in incident events between those with and without a history of past traumatic events;
(2) Examine the associations between incident stressful and traumatic events and changes in health related behaviors (risk behaviors and ART adherence); and
(3) Examine the associations between incident stressful and traumatic events and changes in clinical health-related outcomes (general health, HIV viral load,CD4 count, and OI incidence). The detailed stressful and traumatic event inventory in the CHASE dataset will allow us to consider sexual and physical assault separately as well as stressful events more broadly defined. This program of research will help inform policy and clinical care decisions about the implications of recent stressful and traumatic events for health outcomes and the relative importance of assessing lifetime versus recent stressful and traumatic events in HIV clinical care.
- Principle Investigator: Brian Pence
- Research Associate: Susan Reif
- Effective Dates: 12/2007 – 11/2010
- Partner: University of Alabama, Birmingham