Considering Gender When Exploring HIV-Trauma Therapy Interventions

Living with HIV can be traumatic on multiple levels. For each person it can be extremely different and the treatments must be adapted to each situation and case.

I am increasingly interested in the intersection of mental health and HIV/AIDS. Mental health is something that is not focused on enough when it comes to the complete care of people living with HIV. The differences between men and women are stark and they must be considered when determining the best treatment for trauma and stress. Whether you are newly diagnosed or you have been living with HIV for some time the trauma that you carry with you needs to be explored.

What can you do beyond simply going to a support group?

Availability of support groups can be especially challenging if you live in a geographical location where little to not support is available. So what can you do if you are in that situation? I have found that you must know what you want to get out of therapy in order for it to be successful. Do your research and determine what options are available to you. There is nothing more exciting than when a new client comes to me having done some researcher.

In a study published in the Journal of Consulting and Clinical Psychology, researchers evaluated the benefits of using writing to process trauma as well as the differences that gender played in processing their trauma.

The study concluded that symptoms of PTSD occur at very high rates in people with HIV and are associated with poor disease management and accelerated disease progression. Researchers wanted to evaluate the benefit of using an intervention which utilized a writing component. To complete the study, the researchers had men and women living with HIV split up into randomized groups. One group consisted of four 30-minute writing sessions in either treatment (trauma writing), the other an attention control (daily events writing) condition.

The researchers evaluated outcomes at the start of the study and then at intervals of 1-, 6- and 12-month follow-up. Overall the results were not that remarkable, however, there were significant variants with each gender. Researchers found that gender by treatment group interactions were significant in that women in the trauma-writing group had significantly reduced post-traumatic stress disorder (PTSD) symptoms, depression and HIV-related symptoms compared with their controls within the study. The men however did not experience any significant benefit from participation in the trauma-writing group. Quite unexpectedly, men in the trauma-event-writing control group had significantly greater reductions in depression then men in the trauma-writing group.

In summary, the researchers were able to successfully show that brief (4-session) guided written emotional disclosure intervention resulted in significant and meaningful reductions in PTSD, depression and physical symptoms for women with HIV, but not for men.

Final Thoughts

Whether it be medications or mental health treatment we now understand that a "one-size, fits all" approach cannot and must not be used. Men and women have different strengths and weaknesses, moreover when clinicians, drug companies or the scientific community fail to recognize this fact, a huge opportunity is missed beyond that women are not second-class citizens who have to accept the "scraps" from the table of studies that focus on men.

Information for this article obtained from:
G Ironson, C O'Cleirigh, J Leserman, R Stuetzle, J Fordiani, M Fletcher, N Schneiderman. Gender-specific effects of an augmented written emotional disclosure intervention on posttraumatic, depressive and HIV-disease-related outcomes: A randomized, controlled trial. Journal of Consulting and Clinical Psychology, Vol 81(2), Apr 2013, 284-298.