Physical and sexual abuse in women infected with the human immunodeficiency virus - Increased illness and health care utilization

Background: A history of physical or sexual abuse is associated with increa sed health care utilization and possibly an increase in illness based large ly on self-reported data. Objective: To examine whether victimization experience is associated with i ncreases in documented medical disease and health care utilization among wo men infected with the human immunodeficiency virus (HN). Methods: We interviewed and reviewed medical record data of 50 women seekin g initial primary care for HIV infection at 2 urban hospitals. Women with a nd without a history of physical and sexual abuse were compared. Using mult iple regression analysis, 2 periods were examined: entire life before study entry and the subsequent 2 years. The characteristics examined included ep isodic disease, chronic disease, sexually transmitted disease, chronic pain syndrome, opportunistic infections, obstetrical history, and number of inj uries, surgical procedures, hospitalizations, ambulatory care visits, and e mergency department visits. Results: Evidence of physical or sexual abuse was found in 34 (68%) of the 50 women, of whom 16 (32%) did not disclose during the interview that they were abused. At entry, the rates of episodic disease, chronic pain syndrome , and sexually transmitted disease were greater among those women with hist ories of abuse, At 2 years, episodic disease, chronic disease, injuries, em ergency department visits, and hospitalizations were all more likely in abu sed women. Conclusion: Physical and sexual abuse are common and associated with increa sed medical disease and health care utilization among HIV-infected women.