Violence Exposure, Drug Use and HIV/AIDS Risk Taking Behaviors: The Role of Gender

J Natl Med Assoc. 2020 Oct;112(5):484-502. doi: 10.1016/j.jnma.2019.05.003. Epub 2019 Jun 13.

Abstract

Objective: To examine gender differences among African American young adults in their exposure to violence (ETV) before age 18 and community violence as an adult, and the relationship of these exposures to drug use and HIV risk taking behaviors (HIVRTB).

Method: We detail these experiences in 440 self-identified African Americans, ages 18 to 25, from socio-economically disadvantaged wards in Washington, DC. Factor analysis was used to identify the types of violence experienced before age 18 and as adults. Regression was used to identify which types of violence had the greatest impact on subsequent drug use and HIVRTB.

Results: We found gender differences in the types of violence experienced and their effects on drug use and HIVRTB. For women, the strongest ETV factors were direct personal violence, and exposure to drug sales or physical violence as adults. For men, the strongest factors were feeling unsafe in different situations as adults and exposure to violence among adults before age 18.

Conclusions: We identified the specific kinds of violence that are most likely to impact drug use and risky sexual behaviors that can leave one vulnerable to HIV and how these differ between women and men exposed to both childhood violence and community violence as an adult. Our findings point toward the need for trauma-informed programs that are tailored to gender.

Keywords: African american young adults; Drug use; Exposure to childhood violence; Exposure to community violence; Gender differences; HIV risk taking behaviors.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Exposure to Violence*
  • Female
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Pharmaceutical Preparations*
  • Risk-Taking
  • Sexual Behavior
  • Young Adult

Substances

  • Pharmaceutical Preparations