Master of Science
Epidemiology and Biostatistics
Bauer, Greta B.
Introduction: In Canada, people with HIV are legally required to disclose their HIV status to their sexual partners prior to having sex that presents a “realistic possibility of HIV transmission”. This policy has been criticized for failing to consider the safety and autonomy of women with HIV, which can be compromised following disclosure.
Objectives: To investigate whether experiences of childhood physical or sexual abuse (CPSA) affect barriers to HIV disclosure to partners in adulthood, which include: later physical or sexual abuse, sexual agency, HIV stigma, and perceived social support.
Methods: Propensity scores and inverse probability of treatment weights were used to estimate the difference in barriers to HIV disclosure attributable to CPSA among n=1307 women with HIV. Effects were reported for the total sample, and within ethnoracial groups (Indigenous, Black African, Black Caribbean, white, and “other”).
Results: CPSA increased prevalence of both physical and sexual abuse in adulthood in the total sample and within ethnoracial groups, while effects for other barriers were subgroup specific.
Conclusion: This study illustrates that the environment in which women are legally expected to disclose their HIV status is often characterized by abuse, with high risk of revictimization from childhood to adulthood. While further research should investigate mediating pathways between CPSA and disclosure barriers across ethnoracial groups, this study provides the first targeted evidence suggesting that the causes of HIV disclosure may be more distal and more complex than presumed under Canadian non-disclosure policy.
Churchill, Siobhan M., "Child Abuse as a Determinant of Barriers to HIV Status Disclosure Among Women in Canada" (2018). Electronic Thesis and Dissertation Repository. 5860.