Adverse childhood experiences and disengagement from HIV care: a case-cohort study in Tanzania

Adverse childhood experiences (ACEs) can have lasting, detrimental effects throughout the lifespan and may influence engagement in health care. We conducted a case-cohort study in Tanzania to estimate the association between ACEs and disengagement from HIV care 12 months after initiating antiretroviral therapy (ART) among 217 adults (26 cases and 191 sub-cohort participants). Experiencing one, two, three, and four additional ACEs was significantly associated with 28% (RR<sub>a</sub>= 1.24; 95% CI: 1.05, 1.44; p-value < 0.01), 64% (RR<sub>a</sub>=1.64; 95% CI: 1.22, 2.20), 110% (RR<sub>a</sub>=2.10; 95% CI: 1.35, 3.26), and 168% (RR<sub>a</sub>=2.68; 95% CI: 1.49, 4.38) increases in the risk of disengagement from HIV care, respectively. These findings call for integrated trauma-informed mental health services within HIV care to end HIV/AIDS as a public health threat.

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Journal
AIDS Research and Therapy
Published
2025-06-27
DOI
https://doi.org/10.1186/s12981-025-00760-6
Primary Topic
Child Abuse and Trauma
Type
article
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article

Adverse childhood experiences and disengagement from HIV care: a case-cohort study in Tanzania

Sandra I. McCoy, Susan D. Hillis, Patrick T. Bradshaw, Solis Winters et al.
AIDS Research and Therapy
Child Abuse and Trauma
article

Adverse childhood experiences and disengagement from HIV care: a case-cohort study in Tanzania

Sandra I. McCoy, Susan D. Hillis, Patrick T. Bradshaw, Solis Winters, John M. Colford, Amon Sabasaba, Jennifer Ahern, Emmanuel Katabaro, Laura Packel, Prosper Njau, Matilda Mlowe, Sydney Tucker
article en

Abstract

Adverse childhood experiences (ACEs) can have lasting, detrimental effects throughout the lifespan and may influence engagement in health care. We conducted a case-cohort study in Tanzania to estimate the association between ACEs and disengagement from HIV care 12 months after initiating antiretroviral therapy (ART) among 217 adults (26 cases and 191 sub-cohort participants). Experiencing one, two, three, and four additional ACEs was significantly associated with 28% (RR<sub>a</sub>= 1.24; 95% CI: 1.05, 1.44; p-value < 0.01), 64% (RR<sub>a</sub>=1.64; 95% CI: 1.22, 2.20), 110% (RR<sub>a</sub>=2.10; 95% CI: 1.35, 3.26), and 168% (RR<sub>a</sub>=2.68; 95% CI: 1.49, 4.38) increases in the risk of disengagement from HIV care, respectively. These findings call for integrated trauma-informed mental health services within HIV care to end HIV/AIDS as a public health threat.

AIDS Research and TherapyVol. 22(1)
Ministry of Health, Community Development, Gender, Elderly and Children (TZ), Management and Development for Health (TZ), Imperial College London (GB), University of California, Berkeley (US)
Good health and well-being
Openalex Percentile: Top 79%
Child Abuse and Trauma
DOIOpen Access PDFOpenAlex
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Adverse childhood experiences and disengagement from HIV care: a case-cohort study in Tanzania — Sandra I. McCoy, Susan D. Hillis, et al. · AIDS Research and Therapy (2025) | TGRS Research Map | TGRS