Transgenerational Cycle of Traumatization and HIV Risk Exposure among Crack Users

Int J Environ Res Public Health. 2023 Mar 28;20(7):5285. doi: 10.3390/ijerph20075285.

Abstract

The aim of this manuscript is to understand the impact of childhood sexual abuse on the development of Post-Traumatic Stress Disorder (PTSD), Human Immunodeficiency Virus (HIV) exposure. and parental neglect in crack cocaine users, considering the role of gender. This study is a secondary database analysis of a sample from a multicenter cross-sectional study with 715 crack cocaine users receiving outpatient treatment in public mental health networks in six Brazilian capitals. Prevalence ratios were estimated by Poisson regression. In crack cocaine users with childhood sexual abuse, traumatic experiences seem to remain fixed through the development of Post Traumatic Stress Disorder (PTSD) in adulthood. Crack cocaine users with childhood abuse and PTSD in adulthood showed more sexual risk behaviors, including outcomes such as HIV (PR = 3.6 p < 0.001 for childhood abuse and PR = 3.7 p < 0.001 for PTSD). Furthermore, this traumatic trajectory affects the functional ability of crack cocaine users, especially women, to work thus impacting their inclusion and sense of social belonging. Such a chain seems to be reflected in the establishment of a circle of transgenerational transmission, to the extent that subjects with a history of abuse and PTSD reported more parental neglect towards their children. This study reinforces the importance of preventive public policies regarding early socio-emotional vulnerabilities and the need to support families, especially women, to avoid HIV and self-destructive outcomes such as crack cocaine use.

Keywords: addiction; childhood trauma; crack cocaine; gender; post-traumatic.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Cocaine-Related Disorders* / epidemiology
  • Cocaine-Related Disorders* / psychology
  • Crack Cocaine*
  • Cross-Sectional Studies
  • Female
  • HIV
  • HIV Infections* / epidemiology
  • Humans
  • Sexual Behavior / psychology

Substances

  • Crack Cocaine

Grants and funding

The present study is part of a national project entitled Projeto Ações Integrated, developed by the Research Center on Alcohol and Drugs (CPAD) of Hospital de Clínicas de Porto Alegre (HCPA)—Federal University of Rio Grande do Sul (UFRGS) and by the National Secretariat of Policies on Drugs (SENAD), in collaboration with different sectors of the University and external institutions. Funding for this study was provided by the National Secretariat of Drug Policies (SENAD)—[Project 005/2009 process number 00187.006588/2009-11]. SENAD had no role in the study design, collection, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.