This application presents a program of research and training that focuses on integrating HIV-prevention strategies into mental health treatments for trauma. Specifically, the proposed project aims to develop and pilot test an intervention for HIV-positive adult survivors of childhood sexual abuse (CSA) who are sexually active and exhibit psychiatric distress related to trauma. The widespread prevalence of CSA among HIV+ adults is concerning as CSA has been linked to poor mental health, substance abuse, HIV risk behavior, and poor treatment adherence and outcome. The training objectives are to develop the PI's expertise in: (1) developing culturally sensitive empirically supported mental health treatments for trauma and CSA, (2) integrating HIV-prevention strategies into mental health treatments for trauma and CSA, and (3) learning advanced quantitative data analytic skills for longitudinal data and outcome analysis. Drs. Kathleen Sikkema and John Briere will supervise the training. The primary goals of the proposed project are to: (1) develop a 16 session individual cognitive-behavioral intervention for HIV+ adults with a history of CSA based on self- trauma theory and tailored to meet the needs of those living with HIV;(2) pilot test this intervention with a sample of 80 participants, 40 who will be randomized into an initial treatment condition followed by a four- month follow-up, and 40 who will be randomized into a four-month waitlist condition followed by treatment with the study intervention;and (3) evaluate the intervention's ability to reduce distress and HIV transmission risk behavior, and collect estimates of effect size for future research. This award will result in a intervention that integrates HIV-prevention strategies into mental health treatment for HIV-positive adults who have experienced CSA, a group with elevated risk for HIV-transmission behavior, that can be evaluated in a randomized, controlled intervention trial. The award will also support the PI's long term goal of integrating HIV-prevention strategies into the mental health care of vulnerable populations, such as survivors of trauma.
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