Note to Editors: Two women who graduated from the program are available for interviews.
One is Spanish-speaking.)

One in three American women are sexually abused as children: a staggering statistic that crosses all religious, ethnic and economic backgrounds. It is also the No. 1 predictor for women who contract HIV as adults, according to research by Gail Wyatt, an associate director at the UCLA AIDS Institute.

Now Wyatt's latest study shows that teaching HIV-positive women who were sexually victimized as children how to confront their past and take control of their adult sexuality dramatically lowers their sexual risk-taking and likelihood of infecting others. Graduates of the program were one-and-one-half times more likely to use condoms, reduce their number of sexual partners and take their anti-HIV medications. Reported Dec. 4 in AIDS and Behavior, the new findings suggest an untapped and powerful strategy for helping to contain the HIV epidemic.

"These women's childhoods resulted in low self-esteem that allowed them to be victimized by nearly every man they met," said Wyatt, a professor at the UCLA Neuropsychiatric Institute. "Their abuse influenced every aspect of their sexual behavior, from passivity and denial about their disease to dangerous risk-taking.

"Our program allowed these women to reclaim their own sexuality, which had been stolen from them as children," she said.

In the first program designed for HIV-infected adult survivors of childhood sexual abuse, the 11-week course helped 148 women face their early trauma, recognize that the abuse was not their fault and understand its influence on their lives today. In particular, the program taught the women skills for setting boundaries with men, taking care of their health and assuming responsibility for their lives.

"Many AIDS intervention programs assume that women who contract HIV are promiscuous or prostitutes," Wyatt said. "In reality, we discovered that one-third of the women in our study led celibate lives. For various reasons, this population is not as sexually active as gay and heterosexual men who are living with HIV.'

"Many of the women did not trust men after being hurt by them as children," she said. "In other cases, the women’s partners had died after infecting them with AIDS or had left after the women revealed their HIV status. The women also were concerned about infecting someone else."

Wyatt's team divided the women into small groups led by a trained UCLA counselor and an HIV-positive peer mentor who had graduated earlier from the program. The groups provided a safe and intimate setting where women could reveal their childhood sexual abuse to others for the first time and explore its effects on their current life.

"Our program addressed all aspects of female sexuality in a very empowering way," Wyatt said. "The small groups helped each woman connect the dots between her childhood trauma and her current sexual practices. Once she understood this, she was finally free to separate her past abuse from her future romantic relationships."

Many of the women who had been celibate prior to the program met new partners and became sexually active again. This time, however, they used condoms and followed the steps they had learned during the intervention to build a healthy foundation for their relationship.

"For the first time, these women had a peer group where they could talk about how they met their new partner, explore when to disclose their HIV status, and address how to approach condom use and sexual boundaries," Wyatt said. "Instead of repeating past patterns, the women used the new skills they had learned to begin their relationship in a hopeful and conscious way.

"This is one AIDS story with a happy ending; we witnessed many new romances that led to positive, healthy relationships," she said.

Wyatt and her colleagues are currently training Los Angeles agencies that work with HIV-positive women how to sponsor the skills programs for their clients. Their ultimate goal is to expand the program to a state and national level. They also are leading a similar study for HIV-positive men who suffered sexual childhood abuse, which affects 1 in 4 men in the United States.

UCLA's Hector Myers, professor of psychology, and Tamra Loeb, assistant research psychologist, co-authored the study. The National Institute of Mental Health, UCLA AIDS Institute, Los Angeles Shanti and African Methodist Episcopal Church supported the research.