History of Childhood Sexual Abuse and Unsafe Anal Intercourse in a 6-City Study of HIV-Positive Men Who Have Sex With Men

Abstract

Objectives-To determine frequencies of childhood sexual abuse (CSA) and its demographic and mental health correlates among HIV-positive men who have sex with men (HIV+ MSM).Methods-Cross-sectional analysis of baseline data collected among 593 HIV+ MSM enrolled in the Positive Connections intervention. Data included frequencies of CSA, demographics, and the number of total sex and anal sex contacts contextualized by partners' HIV infection status and condom use.Results-Of participants, 47% reported CSA, with 32% reporting CSA occurring 'often' or 'sometimes.' Men reporting CSA were more likely to be Latino (OR: 2.6) or African-American (OR: 1.8) versus white study participants (p=.0007). CSA reported 'often' or 'sometimes' was associated with increased total sexual contacts (rate ratio: 1.3, for each; p < 0.0001) and unsafe anal intercourse contacts (rate ratio: 1.5 and 2.0, respectively; p < 0.0001) compared with men not reporting CSA.Conclusions-History of CSA is highly prevalent among HIV+ MSM engaging in risk behavior, and appears more common among men of color. Findings suggest that HIV+ MSM reporting CSA are at significantly increased risk for acquiring or transmitting HIV or STI due to increased contact rates versus men without CSA histories.

New Arrivals to New York City: Vulnerability to HIV among Urban Migrant Young Gay Men

“…Similarly, in a study of drug users who migrated to a gay resort area in Florida, mainly from elsewhere in the U.S., Egan et al (2011) hypothesize that increases in drug use and sexual risk may be related to the loss of close family relationships and social and economic capital built up in one's home community. Urban migrant men may also a priori be at greater risk of HIV, as abuse related to sexuality or gender expression can encourage young men to flock to cities with visible gay communities (Bruce & Harper, 2011), and is associated with risky sexual practices and HIV infection (Mimiaga et al, 2009;Stall et al, 2003;Welles et al, 2009).…”

Understanding the Impact of Childhood Sexual Abuse on Men�s Risk Behavior: Protocol for a Mixed-Methods Study (Preprint)

“…This quota falls between estimates from our work with Black MSMW (24% CSA by a female partner) [32] and those reported in two prior studies (CSA range 42% -47%) [9,35]. We will also quota for 40 participants (20 Black, 20 Latino) who have had sex with a woman within the past 12 months (i.e., MSMW).…”

“…In a recent study of MSM with a history of CSA, 42% reported at least one incident of abuse by an older female [9]. Another study found that 20 cases (out of 43) involved a female perpetrator, yet only four of these men initially defined their experiences as abusive [35].…”

“…Although men who engage in same-sex encounters and have a history of CSA tend to be behaviorally bisexual or less likely to identify as gay [9][10][11], it is unclear whether and how the formative sexual experiences of men who have sex with men and women (MSMW) differ from those of MSM only. CSA is associated with adverse consequences among MSM/W including substance use [2,8,9,[12][13][14], poor mental health [8,9,11,[13][14][15][16][17][18][19], high-risk sexual behavior [11,13,14,[19][20][21][22][23], and revictimization [11,15,24]. Yet, investigating these histories is often confounded by underreporting [22,[25][26][27] and varied definitions of abuse [2,[27][28][29][30][31].…”

“…There are a few exceptions [9,32,35]. In a recent study of MSM with a history of CSA, 42% reported at least one incident of abuse by an older female [9].…”