The Relationship Between Adverse Childhood Experiences and Utilization of Different HIV Testing Strategies Among Young Men Who Have Sex with Men in Texas

Abstract

Adverse childhood experiences (ACEs) are a well-documented HIV-risk factor, but less is known about the relationship between ACEs and different HIV testing strategies. This study used data from an LGBTQ + community health assessment, that was part of a multi-staged community-based participatory research project in [Blinded], Texas. Overall, 464 young men who have sex with men (YMSM; < 36-years-old) completed an online, cross-sectional survey that included questions about ACEs and HIV testing behavior. An association between increased ACEs exposure and the odds of clinic-based testing and HIVST HIV significantly decreased relative to never testing for HIV. Additionally, greater ACEs exposure was significantly associated with increased odds of reporting community-based testing (AOR = 1.09, 95% CI = 1.00, 1.20) and significantly reduced odds of HIV self-testing (AOR = 0.72, 95% CI = 0.63, 0.82) compared to clinic-based testing. Cumulative ACEs exposure is important in understanding HIV testing behaviors in YMSM and should be considered when developing HIV testing programs.

Differences in HIV testing among sexual orientation subgroups in the United States: A national cross-sectional study

“…Using this nationally representative sample, people with more ACEs had greater odds of getting tested and this association was equally important for heterosexual concordant and sexual minority individuals. Past research has also shown people with a history of experiencing childhood sexual abuse had a higher prevalence of HIV testing, which is consistent with our finding that people with more ACEs had higher odds of testing ( Blanco et al, 2018 , Schnarrs et al, 2022 ). People with higher educational attainment also had greater odds of HIV testing.…”

“…These stressors include adverse childhood experiences (ACEs) and stressors in adulthood. ACEs are associated with higher odds of community testing and lower odds of self-testing among young adult MSM ( McCabe et al, 2020 , Schnarrs et al, 2022 ). However, there is little research using a national sample of US adults to suggest ACEs and stressors are associated with HIV testing.…”

Adverse childhood experiences and human immunodeficiency virus testing among adults with human immunodeficiency virus risk behaviours

“…(Bertolino et al., 2020) found that participants exposed to any ACE were associated with increased odds of HIV testing sexually transmitted infection (STI) testing among a nationwide sample of men who have sex with men (MSM). In contrast, Schnarrs and colleagues' (Schnarrs et al., 2022) work with MSM in Texas has suggested that increased ACEs exposure was associated with significantly decreased odds of clinic‐based testing and HIV self‐testing (HIVST). Furthermore, one of the first studies reporting a relationship between sexual and physical abuse and sexual risk behaviours in three African countries suggested adults who exposure childhood sexual and physical abuse were more likely to test for HIV voluntarily (Richter et al., 2014).…”