Childhood Sexual Abuse Among Homosexual Men: Prevalence and Association with Unsafe Sex

Abstract

Of 327 homosexual and bisexual men participating in an ongoing cohort study pertaining to risk factors for HIV infection who completed a survey regarding history of sexual abuse, 116 (35.5%) reported being sexually abused as children. Those abused were more likely to have more lifetime male partners, to report more childhood stress, to have lied in the past in order to have sex, and to have had unprotected receptive anal intercourse in the past 6 months (odds ratio 2.13; 95% confidence interval 1.15-3.95). Sexual abuse remained a significant predictor of unprotected receptive anal intercourse in a logistic model adjusting for potential confounding variables. en sexually abused as children may experience several sequelae, such as depression, 1 low self-esteem, 2 sexual promiscuity, 3 interpersonal difficulties, 4 or substance abuse, 5 that might increase their risk of engaging in behaviors associated with HIV transmission. However, there has been little research on the effects of sexual abuse on homosexual men, 6 a group particularly at risk of HIV infection. One study of homosexual and bisexual men recruited from sexually transmitted disease clinics found that 37% of the sample had been sexually abused as children, and that childhood sexual abuse was associated with unprotected anal intercourse, substance abuse, depression, reduced social support, and HIV infection. 7,8 This study examined the potential relation between childhood sexual abuse and unsafe sexual behavior in a cohort of homosexual and bisexual men. We hypothesized that sexual abuse would be prevalent in this population, and that there would be a relation between history of childhood sexual abuse and HIV-related sexual risk taking. METHODS ParticipantsParticipants were homosexual and bisexual men participating in two studies examining factors related to HIV infection at a community health center. 9,10 There were no significant demographic differences between the two studies, and there were similar proportions engaging in unprotected anal intercourse at study entry. Of 422 cohort members, 359 were eligible to participate. Of these, 327 (91.1%) completed the questionnaire. PROCEDUREAt a regular study visit, participants were interviewed about sexual and health behaviors, were tested for HIV, then completed the sexual abuse questionnaire. Appropriate measures were taken to help participants cope with distressing reactions to the questionnaire. Childhood Sexual Abuse Measure Childhood StressParticipants were asked to rate how stressful their childhood was, from 1 (not at all stressful) to 7 (extremely stressful). Definition of Sexual AbuseParticipants were presented with Finkelhor's community standard definition: sexual abuse is a sexual experience with a person at least 5 years older if the child was 12 and under, or 10 years or older if the child is between 13 and 16 inclusive, with or without physical contact, and whether or not sex was wanted by the child. 11 Descriptions of Sexual AbuseParticipants provided their age at the time of the abuse experi...

Exploring the Mental Health of Black Men Who Have Sex with Men

“…The reported prevalence of childhood sexual abuse among MSM in general has ranged from 11 to 37% (Doll et al 1992;Bartholow et al 1994;Lenderking et al 1997;Jinich et al 1998;Paul et al 2001;Traden et al 1999;Kalichman et al 2004), and a study conducted in Minneapolis/St. Paul found a 20% prevalence rate among African-Americans (Brennan et al 2007); however, the African-American sample size was too small to conduct meaningful significance tests.…”

Men's Pathways to Risky Sexual Behavior: Role of Co-Occurring Childhood Sexual Abuse, Posttraumatic Stress Disorder, and Depression Histories

“…5,7,11,12 Not previously reported is the link between CSA and LSPs that appears to occur via PTSD, depression, and comorbid PTSD/depression. Findings revealed that this PTSD/depression linkage appears to be both moderating and mediating in nature, as characterized diagrammatically in Fig.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] Further study of this sexual risk-taking group may ascertain variables that mediate and/or moderate the relationship between CSA and sexual risk behavior.…”

Explanations for Elevated Psychiatric Vulnerability in Nonheterosexuals: Environmental Stressors, Genetics, and the HPA and HPG Axes

“…Though the mechanisms involved are not yet entirely clear, there is mounting evidence that these associations between adverse childhood experiences and psychiatric risk are mediated by permanent effects of repeated stressors on HPA axis reactivity (Heim et al 2008;Pariante and Lightman 2008;Lupien et al 2009;Romeo 2010;Young and Korszun 2010). Several studies have shown elevated rates of childhood sexual abuse and risky family environment in nonheterosexuals (Cameron and Cameron 1995;Lenderking et al 1997;Fergusson et al 1999;Paul et al 2001;Tomeo et al 2001;Balsam et al 2005;Arreola et al 2008;Alanko et al 2009;Zietsch et al in press). A meta-analysis of studies examining the prevalence of childhood sexual abuse in nonheterosexuals (Rothman et al 2011) yielded higher rates than corresponding rates in a meta-analysis of studies of the general population (Stoltenborgh et al 2011).…”