Violence, Trauma, and Mental Health Disorders: Are They Related to Higher HIV Risk for African Americans?

Abstract

HIV disproportionately affects African Americans in the United States (Centers for Disease Control and Prevention (CDC), 2008a), and researchers have sought to understand the proximal and distal causes of this disparity. Although African Americans are knowledgeable about HIV risk factors and report fewer high-risk HIV-related behaviors than other high-risk racial or ethnic populations (Hallfors, Iritani, Miller, & Bauer, 2007; Kaiser Family Foundation, 1998; Millett, Peterson, Wolitski, & Stall, 2006), such knowledge may not translate into engaging in fewer risk behaviors or lower prevalence of HIV in African American communities. To date, most HIV prevention research has focused on determinants of infection at the individual level, such as sociodemographic characteristics and current sexual and drug risk behaviors, or increasing knowledge and improving decision making about behavior and risk. Few research studies focus on these more distal causes of HIV risk behavior, such as trauma and mental health issues. Research that addresses more distal causes of HIV risk behavior is less developed. However, over the past two decades, a growing body of literature suggests that experiences of violence and the psychological ­sequelae that follow, such as depression, stress syndromes, and substance use, may contribute to increased HIV risk behavior among African Americans.