Cognitive Behavioral Therapy for Trauma and Self-Care (CBT-TSC) in Men Who have Sex with Men with a History of Childhood Sexual Abuse: A Randomized Controlled Trial.
AIDS Behav
; 23(9): 2421-2431, 2019 Sep.
Article
em En
| MEDLINE
| ID: mdl-30993478
ABSTRACT
To address childhood sexual abuse (CSA) related distress and HIV risk in men who have sex with men (MSM) using cognitive-behavioral therapy for trauma and self-care (CBT-TSC), which is a novel intervention integrating HIV risk reduction with modified cognitive and behavioral therapy strategies for post-traumatic stress. We compared CBT-TSC to HIV voluntary counseling and testing (VCT)-only in an initial 2-arm RCT in 43 HIV-negative MSM at with a history of CSA and HIV risk. Serodiscordant condomless anal/vaginal sex (CAS; CAS with HIV-postive or HIV unknown status partners) and posttraumatic stress disorder (PTSD) symptoms (Davidson Trauma Scale total score and avoidance, intrusions, hyperarousal subscales) were outcomes immediately post-treatment, and at 6- and 9-month follow-up. At post-treatment, CBT-TSC had decreased odds (approximately 60%) of any CAS and greater reductions in CAS compared to VCT-only. Additionally, the CBT-TSC condition experienced greater reductions in total PTSD and avoidance symptoms. At the follow-up visits, CBT-TSC condition had significant reductions in the odds of any CAS and reductions in CAS. However, for PTSD symptoms, only the avoidance subscale remained significantly different compared to VCT-only. CBT-TSC is a potentially efficacious approach to address HIV risk in MSM with a CSA history, with replication and extension in a larger trial needed. This proof-of-concept trial is the first to integrate the treatment of a commonly occurring mental-health syndemic problem in MSM with a health psychology approach to self-care in MSM.Trial Registration Clinicaltrials.gov NCT01266122.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Autocuidado
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Transtornos de Estresse Pós-Traumáticos
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Abuso Sexual na Infância
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Terapia Cognitivo-Comportamental
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Infecções por HIV
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Programas de Rastreamento
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Aconselhamento
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Sobreviventes Adultos de Maus-Tratos Infantis
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Prognostic_studies
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Screening_studies
Limite:
Adult
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Child
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Humans
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Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article