JOURNAL OF COMMUNITY PSYCHOLOGY, Vol. 33, No. 6, 655–672 (2005) © 2005 Wiley Periodicals, Inc. Published online in Wiley InterScience (www.interscience.wiley.com).DOI:10.1002/jcop.20077 This research was supported by grants RO1-MH62965 (awarded to Kathleen Sikkema, Ph.D.), P30-MH62294 (Center for Interdisciplinary Research on AIDS; CIRA), and T32-MH20031 from the National Institute of Mental Health. The authors gratefully acknowledge our community collaboration with the Callen-Lorde Community Health Center in New York City, and Liberty Community Services and the Nathan Smith Clinic in New Haven. We are grateful to Nathan Hansen and Rachel Lee for their assistance in conducting the inter- views, and to Kevin Irwin for his review of earlier versions of the manuscript. Correspondence to: Nalini Tarakeshwar, Ph.D., The Consultation Center, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT 06511; e-mail: nalini.tarakeshwar@yale.edu THE CONNECTIONS BETWEEN CHILDHOOD SEXUAL ABUSE AND HUMAN IMMUNODEFICIENCY VIRUS INFECTION: IMPLICATIONS FOR INTERVENTIONS Nalini Tarakeshwar, Ashley Fox, Carol Ferro, Shazia Khawaja, Arlene Kochman Yale University School of Medicine Kathleen J. Sikkema Yale University School of Medicine and Yale University A qualitative study was conducted with 28 women who are human immunodeficiency virus (HIV)–positive and have experienced childhood sexual abuse (CSA) in order to examine (1) the challenges generated by the experience of sexual abuse and related coping strategies, (2) the impact of the HIV diagnosis on their coping strategies, and (3) the links perceived by the women between their CSA and HIV infection. The interviews revealed that CSA raised challenges in four areas: disclosure of the abuse, sexual problems, relationship difficulties, and psychological distress. The women used two strategies to cope with their CSA: illicit substances to numb their emotional distress and sexual activity, and alienation to gain control in relationships. When diagnosed with HIV, the women initially coped with their illness by using these two strategies. The women reported that, over time, they were able to accept their HIV illness, seek social support, find alternative sources of significance, and use spirituality to sustain their growth. However, they continued to suffer psychological distress related to their sexual trauma. ARTICLE