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Women, Trauma and HIV

November 12, 2015

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Women, Trauma and HIV

Table of Contents


Several studies have shown that experiences of trauma are much more common among girls and women living with HIV (HIV+) than among those in the general population. So what is trauma, and what is its relationship with HIV?

What Is Trauma?

Trauma generally refers to a deeply disturbing or distressing experience -- something that involves serious injury or emotional wounding. Trauma can result from a situation, an event, or a series of events that you experience as physically and/or emotionally harmful. A traumatic experience can have long-lasting negative effects on your regular ability to function as well as on your mental, physical, social, emotional, and spiritual well-being.

A key thing to understand about trauma is that it is your experience of an event or situation as deeply disturbing that makes it traumatic. Different people will have different experiences of the same event. While some people will find a particular situation traumatic, others may not find it as distressing and not be as affected by it.

Examples of potentially traumatic life experiences include:

  • Natural disasters, such as hurricanes, floods, fires, or earthquakes
  • War or political violence, including being forced to move (refugee)
  • Sudden violent or unexpected death of a loved one (e.g., murder, suicide, accident, heart attack)
  • Death of a parent
  • Physical, emotional, or sexual abuse (e.g., domestic violence, intimate partner violence, sexual assault, rape, incest)
  • Serious injury, illness, or accident (e.g., severe burns, cancer, car accident)
  • Childhood neglect (when basic needs for food and/or shelter are not met)

There are also some factors that can increase people's vulnerability to trauma. Having recently suffered losses or already being very stressed when a new event occurs can increase the likelihood that you are traumatized by that event. In general, people are more likely to be traumatized if they've been traumatized before. This is especially true if the previous trauma occurred during childhood. When a child's sense of security or safety is threatened, she or he may grow up seeing the world as an unsure, dangerous, and frightening place. This can cause the child to develop emotionally and physically in ways that make it easier for her/him to be traumatized by future situations.

"Everything happened when I was six years old that I lost my mother and then I stayed with my father. I was nine years old; I was being abused by him -- sexually. Well I was being abused until I turned 12 years old.
-- Marta Z., Christie's Place
"We grew up in an alcoholic home and an abusive home. I remember as a child witnessing my mom getting beat up and going to jail and being drunk. It was so normal that, you know, we didn't think nothing of it. That was just a daily part of our life ... So at the age of 12 I started smoking weed. When I was 12 that was also the year my father died, which was very, very hard for me ... I was sexually assaulted by my stepbrother when I was about 12 or 13 as well ...
-- Jay B., Christie's Place

Post-Traumatic Stress Disorder (PTSD)

Most survivors of trauma have some stress-related reactions after a traumatic event. This is normal, and most people feel like themselves again with time. However, some people have stress reactions that do not go away and may even get worse over time. These people may have PTSD. PTSD is a mental health disorder that includes four types of symptoms:

  • Re-living or re-experiencing the trauma in the form of nightmares or flashbacks (intense memories of past events), or when triggered by reminders of the original experience
  • Avoiding or staying away from people, places, or activities that remind a person of the original traumatic event
  • Feeling keyed up, on guard, jittery, or irritable. The body and mind remain hyperaroused, or hypervigilant, which can lead to trouble sleeping or to startling easily (e.g., jumping sky-high when a balloon pops)
  • Changes in mood and thinking (e.g., depression, anxiety, problems with memory, difficulty concentrating). These often include losing interest in once pleasurable activities, a sense of being detached from others, trouble experiencing a full range of feelings, and feeling constant shame, guilt, or horror.

PTSD can be a very disabling disorder, as it can lead to problems with substance abuse, job stability, parenting, and social and familial relationships.

Effects of Trauma

You may be wondering how this topic affects you, especially if you do not have PTSD. It is important to remember that it is our experience of an event that makes it traumatic, and you do not have to have PTSD to suffer from the effects of trauma.

By definition, trauma results in lasting negative effects on a woman's ability to function in the world -- physically, mentally, emotionally, socially, and/or spiritually. See if any of these effects ring true for you. Trauma can affect a woman's:

  • Worldview and perceptions of safety (e.g., the universe as a generally safe, friendly place versus a threatening, hostile place)
  • Purpose and personal identity:

    • her identity as a woman, mother, partner, community member, student, professional, etc.
    • her goals and dreams, and how much a woman feels she has the ability to make things happen in her life
  • Relationships with others: how a woman shows up in friendships, work relationships, intimate relationships, family relationships; decisions about which relationships to pursue as well as how close or distant to be in them
  • Health and well-being: Trauma has negative effects on women's overall health. For women living with HIV, a history or trauma or PTSD can lead to higher rates of non-adherence to HIV drugs and consequent treatment failure, higher rates of death, and poorer quality of life.
  • Emotional awareness and expression: Because emotional responses to trauma can be so overwhelming, women who have lived through trauma sometimes regard having emotions as unsafe. This can lead them to have trouble knowing or talking about what they feel, become easily overwhelmed by feelings, feel angry at themselves when they have feelings, feel numb, or feel angry at others when they feel vulnerable. Not being aware of or able to express feelings can negatively impact women's abilities to make good decisions, act effectively, and have healthy relationships with others.
And then after that I came to the United States to live with one of my sisters. And when I was staying with her, I was also being abused by her husband ... So I left. That's when I started drinking -- so bad. Real, real bad ... Then I went to this other city where I started prostituting myself. Because, you know, I needed to survive. That was the only way that I can make it... because I didn't have no spirits at all.
-- Marta Z.
So I got into heavier drugs in high school and I would have lots of sex partners -- I was just trying to find that love in my life and acceptance ... So I would have sex at the drop of a dime ... And along with that came those partners that beat you and want to control you, and I accepted all that 'cause I thought it was love. I thought that men that put their hands on you, if you didn't do that, you didn't love me ...
-- Jay B.
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This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.

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