Violence and Victims

Perceived stigma in clinical settings may discourage HIV-infected individuals from accessing needed health care services. Having good access to care is imperative for maintaining the health, well being, and quality of life of persons living with HIV/AIDS (PLWHAs). The purpose of this prospective study, which took place from January 2004 through June 2006, was to evaluate the relationship between perceived stigma from a health care provider and access to care among 223 low income, HIV-infected individuals in Los Angeles County. Approximately one fourth of the sample reported perceived stigma from a health care provider at baseline, and about one fifth reported provider stigma at follow up. We also found that access to care among this population was low, as more than half of the respondents reported difficulty accessing care at baseline and follow up. Perceived stigma was found to be associated with low access to care both at baseline (odds ratio [OR] = 3.29; 95% confidence interval [CI] = 1.55, 7.01) and 6...

The effect of perceived stigma from a health care provider on access to care among a low-income HIV-positive population.

We review treatment studies for comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD). Results show positive outcomes on multiple domains. Most models had more effect on PTSD than SUD, suggesting SUD is harder to treat. Seeking Safety (SS) is the most studied model. It shows positive outcomes, and is the only treatment outperforming a control on both PTSD and SUD. Partial-dose SS had more mixed results than the full dose. This first-generation of PTSD/SUD research addresses complex samples excluded from "gold standard" PTSD-alone literature. Treatments for PTSD/SUD are generally longer than PTSD-alone treatments and present-focused, emphasizing stabilization and coping. The few models with past-focused (exposure-based) components also incorporated present-focused approaches for these vulnerable clients. We discuss public health perspectives to advance the field.

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Helping vulnerable populations: a comprehensive review of the treatment outcome literature on substance use disorder and PTSD.

Psychological treatments for concurrent posttraumatic stress disorder and substance use disorder: A systematic review

Health care professionals who routinely interact with young people have an important role to play in preventing, identifying, and responding to commercial sexual exploitation and sex trafficking of minors. These crimes—which include any sexual activity with someone younger than 18 years in exchange for something of value—occur every day in the United States and have serious, long-term consequences for individuals who have experienced this violence and exploitation. Unfortunately, pediatricians may not recognize children and adolescents who are at risk or who may be abused. A recent report from the Institute of Medicine and the National Research Council sheds light on these crimes and provides recommendations designed to increase awareness, advance understanding, and support efforts to prevent and respond to this abuse.... Language: en

Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States was authored by the IOM/NRC Committee on the Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States:

There is growing recognition of the complex needs of women with dual diagnoses of substance abuse and mental health disorders. Recent research indicates that 55% to 99% of women with co-occurring disorders have experienced trauma from abuse and that abused women tend to engage in self-destructive behaviors. These women often are not well served by the services found in their communities, which separate substance abuse and mental health programs, despite the fact that research shows that integrated, trauma-informed treatment services will increase the success of their recovery. A recent study examined the use of two gender-responsive, trauma-informed curricula presented in a residential facility for women, 55% of whom had criminal histories. Helping Women Recover and Beyond Trauma are both manualized programs founded on research and clinical practice and are grounded in the theories of addiction, trauma, and women's psychological development. This treatment model is named "Women's Integrated Treatment" (WIT). Women who successfully completed the programs were assessed at several points in time on several scales, including trauma symptomology, depression, and substance use before and after the programs. The findings indicated less substance use, less depression, and fewer trauma symptoms (p < or = .05)--including anxiety, sleep disturbances, and dissociation--after participation in the WIT curricula.

Evaluation of a trauma-informed and gender-responsive intervention for women in drug treatment.

Between 1987 and 2003, an objective measure of recent drug use from a high-risk group was collected as part of a federally-funded program called ADAM (Arrestee Drug Abuse Monitoring). The information collected as part of this project supplemented other self-report data collected across the country with the general population. San Diego County was one of the original ADAM sites, and with local funding support was able to maintain the essential aspects of the program uninterrupted when national support was discontinued. In May 2006. the results of data collected in calendar year 2005 as part of a standard interview with adult and juvenile arrestees, urinalysis. as well as a methamphetamine (meth) addendum were presented at the Substance Abuse Research Consortium (SARC) meeting in Pasadena, California. This article provides a summary of these descriptive data, including a profile of recent meth users, reasons for initiating and continuing use. patterns of use, and trends in use over time. Additional...

Cynthia Burke

Papers

Evaluation of a trauma-informed and gender-responsive intervention for women in drug treatment.

Methamphetamine Use Among San Diego County Arrestees