Neural Correlates of Childhood Sexuall Abuse & HIV-Related Sexual Behav in Women

Meharry Medical College, Nashville TN

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Abstract

African-American women are the fastest growing population contracting Human Immunodeficiency Virus[unreadable] (HIV). Infection is commonly in the context of heterosexual intercourse with unsafe sexual practices and is[unreadable] independent of psychiatric diagnosis or substance dependence co-morbidity. A history of childhood sexual[unreadable] abuse (CSA) has been linked to increased risk of. HIV infection, with increasing intensity and chronicity of[unreadable] abuse associated with increasing risk. Imaging studies examining effects of stress have identified the medial[unreadable] prefrental cortex, hippocampus, and amygdala (medial temporal lobe) as brain regions that are particularly'[unreadable] vulnerable. Importantly, these are areas associated with emotion, memory or decision processing. The goal[unreadable] of the proposed studies is to test the hypothesis that childhood sexual abuse, especially in African-American[unreadable] women, leads to sustained changes in neural circuits even as adults and that these changes predispose[unreadable] sexually abused women to impaired decision making when making choices regarding unsafe sexual[unreadable] behaviors. This hypothesis will be tested by: 1) rigorous clinical description of adult African American and[unreadable] Caucasian women self reported to have experienced CSA; 2) psychological assessment of executive[unreadable] decision making with the Stroop Test, the Emotional Stroop Test, and the Iowa Gambling Task; 3) functional[unreadable] magnetic resonance imaging (fMRI) of the decision-making and behavioral inhibition neural circuits activated[unreadable] by provocation with the Stroop Test, Emotional Stroop, Iowa Gambling Task; and 4) correlation of the[unreadable] objective CSA data with the neuropsychological and functional imaging data. If, as we postulate, women[unreadable] with CSA have significant alterations in thought processes that increase risk of dangerous sexual behavior[unreadable] then defining the brain circuits altered may suggest therapeutic strategies in the future. Comparison of both[unreadable] CSA+ African American and Caucasian women with age-, education, and socio-economically matched[unreadable] control subjects without CSA histories will also reveal possible racial differences in CSA-provoked changes.