Childhood Adversities and Physical and Mental Health Outcomes in Adults Living with HIV: Findings from the Ontario HIV Treatment Network Cohort Study

Abstract

We sought to estimate the prevalence of childhood adversity and examine its relationship with health outcomes among people living with HIV. Study participants included 1409 adults living with HIV and receiving care in Toronto, Canada. Data on childhood adversity, health behaviors, HIV outcome measures, depression, and health-related quality of life (HRQOL) were collected through face-to-face interviews and medical records. Statistical analyses included multivariable linear and logistic regression modeling. The prevalence of any childhood adversity was 71% (individual types ranged from 11% to 44%) and higher prevalence was associated with younger age, Indigenous or African/Caribbean/Black ethnicity, lower socioeconomic status, and higher rates of cigarette smoking and nonmedicinal drug use. Greater number of childhood adversities was associated with greater odds of depression and decreasing mental HRQOL. HIV care providers need to screen for childhood adversities and address childhood trauma within the context of HIV care.

Figure 1

Prevalence of depression (CES-D ≥ 16) by number of childhood adversities. Note. Trend was significant (Chi-square trend test; χ² = 99.0; p < 0.001).

Figure 2

SF-36 PCS and SF-36 MCS scores by number of childhood adversities. Note. There was a significant linear trend for SF-36 MCS score (ANOVA trend test; F = 77.2.9; p < 0.001), but not for SF-36 PCS score (ANOVA trend test; F = 2.2; p = 0.134).