Immediate and delayed suggestibility among suspected child victims of sexual abuse

Children suspected of being victims of sexual abuse are often interviewed by police, but little is known about the effects of sexual abuse on their suggestibility. The aim of this paper was to investigate differences in ‘immediate’ and ‘delayed’ suggestibility between children being investigated as suspected victims of sexual abuse and other children and to compare the suggestibility scores of children allegedly abused by a family member versus a person from outside the family. The participants were 180 children aged between 7 and 16 years, who had been subdivided into ‘victim’ and ‘control’ groups; each group being comprised of 90 children and matched for IQ. All children completed the Gudjonsson Suggestibility Scale (GSS 2) and a non-verbal IQ test. The children in the victim group scores significantly higher on Shift and Yield 2 than the control group, after controlling for memory capacity. Children abused by a family member coped significantly worse with interrogative pressure (high Shift) than those abused by a non-family member. Immediate suggestibility showed much stronger effects than delayed suggestibility. The findings suggest that sexually abused children are very vulnerable during questioning where there is interrogative pressure and those abused by a family member are even more vulnerable.     

Effects of tobacco use on non-adherence to antiretroviral therapy among HIV-positive patients in South Africa

This study aimed to estimate the relationship between tobacco use and non-adherence to antiretroviral therapy (ART) in a South African sample. Participants were 1 963 HIV patients who attended a primary care clinic in Pretoria (female = 68.5%; black African = 99.5%; median age = 37.0 years; tobacco users only = 8.6%, problem drinkers only = 14.9%, and tobacco users and problem drinkers = 10.5%). In adjusted logistic regression analysis, tobacco use only was not significantly associated with non-adherence to ART. Alcohol use only (OR: 1.72; CI: 1.26, 2.36) and tobacco use and problem drinking (OR: 2.31; CI: 1.60, 3.33) were highly associated with non-adherence to ART.     

Prior interpersonal trauma: the contribution to current PTSD symptoms in female rape victims

The purpose of the current study was to disentangle the relationship of childhood sexual abuse and childhood physical abuse from prior adult sexual and physical victimization in predicting current posttraumatic stress disorder (PTSD) symptoms in recent rape victims. The participants were a community sample of 117 adult rape victims assessed within 1 month of a recent index rape for a history of child sexual abuse, child physical abuse, other adult sexual and physical victimization, and current PTSD symptoms. Results from path analyses showed that a history of child sexual abuse seems to increase vulnerability for adult sexual and physical victimization and appears to contribute to current PTSD symptoms within the cumulative context of other adult trauma.     

Supportive and unsupportive responses of others to rape victims: Effects on concurrent victim adjustment

Evaluated the impact that actions of significant others have on adjustment following rape. Significant other behavior is conceptualized as having two dimensions--supportive behavior and unsupportive behavior--and each dimension was measured using multiple items. Unsupportive behavior, but not supportive behavior, was found to bear a significant association to victim adjustment. Implications for those who work with victims are discussed.     

HIV/AIDS in South Africa: a review of sexual behavior among adolescents

South Africa has a fast-growing HIV/AIDS rate, with the highest prevalence among young people (15 to 24 years), especially females. This paper is a comprehensive analytical review of available research concerning the sexual behavior of adolescents in South Africa. It offers insight into HIV infection among adolescents and provides an important base for educational interventions aimed at behavior change and reducing further transmission. The most important conclusion is that, despite the research (however limited) that has been done, there has been no significant change in the rate of infection among adolescents in South Africa. A new generation of behavioral interventions, involving both factual knowledge and life skills to promote behavioral risk reduction, is recommended.     

An examination of risky sexual behavior and HIV in victims of child abuse and neglect: a 30-year follow-up.

OBJECTIVE: This article examined links between childhood maltreatment and risky sexual behavior (early sexual contact, promiscuity, prostitution) and HIV in adulthood. DESIGN: Using a prospective cohort design, physically and sexually abused and neglected children (ages 0-11) with documented cases during 1967-1971 were matched with nonmaltreated children and followed into adulthood. MAIN OUTCOME MEASURES: Early sexual contact, promiscuity, and prostitution were assessed through in-person interviews and official records (prostitution) at approximate age 29 (N=1196). HIV tests were conducted at approximate age 41 (N=631). RESULTS: Child maltreatment was associated with prostitution (OR=2.47, 95% CI=1.35-4.50) and early sexual contact (OR=1.73, 95% CI=1.24-2.40). Prevalence of HIV in the abuse/neglect group was twice that in controls (OR=2.35, 95% CI=.64-8.62), although this difference did not reach conventional levels of statistical significance. SEM provided significant support for a model linking child abuse and neglect to prostitution through early sexual contact and a marginal link to HIV through prostitution. CONCLUSION: These findings provide prospective evidence that maltreated children are more likely to report sexual contact before age 15, engage in prostitution by young adulthood, and test positive for HIV in middle adulthood.     

The attitudes toward rape victims scale: Reliability and validity in a chinese context

Two studies were conducted to assess the cross-cultural applicability of Ward's Attitudes toward Rape Victims Scale (ARVS). In the first study, 202 Chinese college students took the ARVS, the Attitudes toward Women Scale, and the Traditionality-Modernity Factor Scale. Reliability and convergent validity were established for ARVS. In the second study, construct validity of the ARVS was further examined, using the known-group method. The scores of four professional groups were compared. Consistent with previous studies, women showed significantly more favorable attitudes toward the rape victims than men. The findings generally suggest that the ARVS is promising in further cross-cultural research and application.     

Identity status and perceived parenting style in adolescents living in central South Africa

This study investigated the relationship between black South African adolescents’ identity statuses and their perceived parenting styles. Participants (n = 188; 66% = females) were from central South Africa. They completed the Objective Measure of Ego Identity Status and the Parental Authority Questionnaire in addition to a biographic survey that included questions on their family structures (nuclear, extended, other types). Findings suggest that diffused and achieved identity statuses relate to perceived authoritative and permissive parenting styles respectively. Results bring into question the universality of Western identity development and parenting style theories.     

Use of traditional medicine by HIV-infected individuals in South Africa in the era of antiretroviral therapy

As antiretroviral therapy (ART) becomes more available in African countries, the potential for interaction with traditional medicines becomes more important. We carried out a cross-sectional survey among individuals with moderate or advanced HIV disease attending a workplace clinic providing ART in South Africa to determine prevalence of traditional medicine use, source, recommended products and costs. Among 44 clinic attendees (100% male, median age 42 years, 30 taking ART), 37 (84%) reported ever using traditional medicines, 25 obtained from a healer or herbalist, eight from their own fields and four from a pharmacy. Fourteen of the 44 (32%) were currently using traditional medicines, most frequently African potato (9/14) and Aloe vera (3/14). Seven out of 30 persons taking ART (23%) reported currently using traditional medicines. Participants spent 4 - 27 pounds per month on traditional medicines. Traditional medicine use is common among individuals with moderate and advanced HIV disease. Concomitant use with ART has the potential for drug interactions and should be discussed routinely in ART counselling. Further work is warranted to investigate whether commonly used traditional medicines interact with ART in vivo.     

Differences between Japanese and American college students in giving advice about help seeking to rape victims

In this study, the author investigated differences in Japanese and American college students' tendencies to advise a hypothetical rape victim (their sister) to seek help from police, family members, or mental health professionals. Japanese students tended to encourage the victim to seek help from her family members, whereas American students tended to encourage her to seek help from police and mental health counselors. Cross-cultural discrepancies were marked by the following factors: (a) feelings of shame moderated advice to seek help from police; (b) minimization of rape mediated the likelihood to advise the involvement of police and mental health counselors; (c) attitudes toward mental health counselors mediated advice to seek help from them; and (d) the type of rape (stranger vs. date rape) moderated advice to report the crime to police.     

HIV risk perceptions and first sexual intercourse among youth in Cape Town South Africa

CONTEXT: HIV prevalence is high among South African youth. Health behavior models posit that the perceived level of risk of HIV infection is associated with the level of HIV risk behavior; however, there has been limited research in Sub-Saharan Africa on factors associated with perceived risk or on the relationship between perceived risk and risk behaviors. METHODS: Longitudinal data collected in 2002 and 2005 from 3,017 black, colored and white youth in Cape Town, South Africa, were analyzed using multivariate regression to examine whether a reciprocal relationship exists between sexual experience and perceived HIV risk. Independent variables taken from the 2002 survey were used to predict dependent variables taken from the 2005 survey. RESULTS: In 2005, most youth (82% of males and 83% of females) viewed themselves as being at no or small risk of HIV infection. A reciprocal relationship in which higher perceived HIV risk was associated with a delay in sexual debut (odds ratio, 0.8) and sexual experience was associated with higher perceived risk (1.4) was found for females, but not for males. Knowing someone who had died of AIDS was associated with sexual debut and with an elevated perceived HIV risk among females (1.7 and 1.3, respectively). The associations between race and perceived risk of HIV infection varied by gender. CONCLUSIONS: HIV/AIDS education and prevention programs should consider more carefully how gender and race may intersect to influence risk perceptions and risk behaviors. In addition, possible reciprocal relationships between risk behaviors and risk perceptions should be considered in education and intervention programs.     

Two strategies to increase adherence to HIV antiretroviral medication: life-steps and medication monitoring

Advances in the medical treatment of HIV have made it clear that adherence to highly active antiretroviral treatment is a crucial feature for treatment success. The present paper had two goals: (1) to examine psychosocial predictors of adherence in persons receiving HIV antiretroviral therapy; (2) to compared two minimal-treatment interventions to increase HIV medication adherence in a subset of persons who self-reported less than perfect adherence. One of the interventions, Life-Steps, is a single-session intervention utilizing cognitive-behavioral, motivational interviewing, and problem-solving techniques. The other intervention, self-monitoring, utilizes a pill-diary and an adherence questionnaire alone. Significant correlates of adherence included depression, social support, adherence self-efficacy, and punishment beliefs about HIV. Depression was a significant unique predictor of adherence over and above the other variables. Both interventions yielded improvement in adherence from baseline, and the Life-Steps intervention showed faster improvements in adherence for persons with extant adherence problems.     

Formal Employment and Health-Related Quality of Life among People Living with HIV in South Africa

This study examined the link between formal employment and characteristics of the workplace (especially awareness of workplace HIV policies and HIV status disclosure to work colleagues) and health-related quality of life (HRQoL) among people living with HIV (PLHIV). The study analysed medical treatment and employment history since first being diagnosed as HIV-positive among 554 adults, 55 % females, who had been on HIV treatment for at least 2 years in South Africa. Additional cross-sectional data on HRQoL were collected using the Medical Outcomes Study 36-Item Short Form (SF-36) (QualityMetric Incorporated). Two hundred and forty four (44 %) of the study participants (39 % and 49 % among males and females, respectively) were formally employed at the study interview. Formally employed study participants reported higher HRQoL than those not formally employed, as reflected in mean scores in the physical and mental component summaries of the SF-36 instrument. HRQoL was unrelated to study participants’ CD4 count, viral load and duration since HIV diagnosis. Among the formally employed study participants, 27.9 % reported awareness of workplace HIV policies in their organisations, while 50.8 % said they had disclosed their HIV status to work colleagues. The awareness of workplace HIV policies was associated with higher mental component summary scores after controlling for study participants’ socio-demographic characteristics, but had no significant association with the physical component summary scores. The disclosure of HIV status to work colleagues was associated with neither mental nor physical component summary scores. The finding of a positive association between formal employment and HRQoL among PLHIV suggest the need for facilitative interventions for employment entry and continuation among PLHIV for their wellbeing.     

Neurodevelopmental delay among HIV-infected preschool children receiving antiretroviral therapy and healthy preschool children in Soweto, South Africa

Neurodevelopmental delay has been documented in up to 97.5% of HIV-infected children in Soweto who were not yet on antiretroviral treatment (ART). With growing numbers of children in South Africa being successfully treated with ART, the effects of ART on neurocognitive functioning in children require investigation. The objective of this study was to determine the extent of neurodevelopmental delay in stable HIV-infected preschool children (aged five to six years) receiving ART and compare it to an apparently healthy (unconfirmed HIV-status) group of preschool children. Thirty HIV-infected preschool children (virologically and immunologically stable on ART for more than one year) were conveniently sampled from 350 eligible children on ART at the Harriet Shezi Children's Clinic in Soweto, Johannesburg. The comparison group comprised 30 well-nourished preschool children attending the Lilian Ngoyi Primary Health Care Clinic in Soweto for routine immunizations. Each child was assessed using the Griffiths Mental Development Scales-Extended Revised Version (GMDS-ER), at a single point in time. The overall developmental z-scores on GMDS-ER were <-2 (indicating severe delay) in 27 (90%) children in the HIV-infected group compared to 23 (76%) in the comparison group (p?=?0.166). Mental handicap (overall GQ?相似文献   

Healing the betrayed: Issues in psychotherapy with child victims of trauma

Over the last few years there has been a tremendous upsurge of research on child victims of trauma. However, very little has been reported on the process of psychotherapy with traumatized children. The purpose of this paper is to assess the role of countertransference and the use of a treatment parameter that has been tried in several individual cases of victimized children and found to be of value.     

Perceptions of rape victims and assailants: Effects of physical attractiveness,acquaintance, and subject gender

Subjects read different versions of a rape case in which the victim was walking alone at night and the defendant was obviously guilty. Female subjects saw the crime as more debilitating for the victim and were more punitive than male subjects. Female subjects considered the victim less responsible when the defendant was unattractive than when the defendant was attractive. Presence or absence of prior casual acquaintance between the victim and assailant interacted with other factors. With prior acquaintance, male subjects considered the victim more responsible than female subjects, unattractive victims were considered more responsible than attractive victims, and unattractive defendants were considered more likely to engage in future antisocial behavior than attractive defendants. Although biased by other factors, level of victim blame was low overall. Yet subjects seemed reluctant to believe the rapist and his victim were unacquainted and seemed to consider the rape as sexually, rather than aggressively, motivated.The authors gratefully acknowledge the helpful comments of Andrea R. Halpern and T. Joel Wade. Portions of this paper were presented at the meetings of the Eastern Psychological Association, Buffalo, New York, April 1988.     

Counsellor-delivered HIV risk reduction intervention addresses safer sex barriers of people living with HIV in KwaZulu-Natal, South Africa

This study developed an HIV risk reduction intervention for people living with HIV (PLWH) obtaining care at primary healthcare clinics in KwaZulu-Natal, South Africa by (1) conducting elicitation research to understand the dynamics of risk behaviour among PLWH, (2) modifying an existing HIV risk reduction intervention based on research findings and (3) conducting a pilot study to evaluate feasibility, acceptability and fidelity of the modified intervention implemented by trained lay counsellors at a rural clinic in KwaZulu-Natal. A total of 61 healthcare providers and 77 HIV+ patients from four primary healthcare clinics participated in 14 focus groups and 20 individual interviews to identify informational, motivational and behavioural skills (IMB) factors contributing to PLWH's sexual risk behaviour. Elicitation research findings were incorporated into a revised version of Options for Health, an evidence-based risk reduction intervention for PLWH in clinical care. In a 5-day training, lay counsellors learned strategies to address IMB barriers to safer sex identified in elicitation research. The revised intervention, which was implemented by six counsellors with 39 patients, was feasible to implement, acceptable to patients and counsellors, and implemented with good fidelity. This study makes an important contribution towards development of a theory-based HIV risk reduction intervention for PLWH linking prevention with treatment in South Africa.