The Role of Sociocultural Factors in the Association between Sexual Violence and HIV Susceptibility

Introduction: Disparities in sexual violence and HIV infection are paramount among Black and Latina adolescent girls and adult women in the United States. Sexual violence is an established risk factor for HIV acquisition. Yet, the underlying biological mechanisms explaining this association is less understood, as are potential differences by racial and ethnic groups. Racial and ethnic minorities may be at heightened biological risk due to chronic stress exposure from sociocultural factors, including norms around violence, medical mistrust, and discrimination, in addition to genetic variants, which may alter inflammation systemically and locally in the female genital tract. Collectively, these factors may lead to an increased susceptibility to HIV infection.

Methods: The parent study, entitled The THRIVE Study is a case-control study of cis-gender women aged 14 to 45 experiencing recent sexual violence (cases) or consensual vaginal sex (controls). The present analyses will be conducted utilizing data from 30 women, equally distributed across racial/ethnic groups, including Black/African American (n=10), Latina/Hispanic (n=10), and White (n=10). Both biological data and quantitative data are collected at the study visit. Quantitative data include demographic characteristics, gynecologic and reproductive history, substance use, sexual behavior, mental health status, and sociocultural measures (e.g. discrimination, medical mistrust, law enforcement mistrust, gender roles, and sexual relationship power). Descriptive analyses will be conducted to assess differences in demographic and sociocultural variables stratified by case/control status and racial/ethnic groups.

Results: Anticipated results include significant differences in sociocultural factors by exposure to sexual violence (cases and controls). We also anticipate significant differences among Black/African American and Latina/Hispanic women when compared to White women. Finally, we will document relationships between sexual trauma status (cases and controls) and HIV risk behaviors (sexual behaviors and substance use) and mental health indicators with increased odds expected for women with recent sexual trauma experiences.

Conclusions: Increased understanding of how sexual violence may be associated with sociocultural factors to promote HIV susceptibility is imperative to HIV prevention. Given the possibility of increased susceptibility among Black and Latina women due to genetic and sociocultural factors, is it particularly important to explore this relationship with consideration for health disparities. Findings from this research will facilitate future hypothesis-driven longitudinal research and the development of culturally-tailored HIV prevention strategies