CSA and the sociocultural context of sexual risk among adult Latino gay and bisexual men

Objectives. We sought to examine the relationships among childhood sexual abuse, social discrimination, psychological distress, and HIV-risk among Latino gay and bisexual men in the United States.

Methods. Data were from a probability sample of 912 men from Miami, FL; Los Angeles, CA; and New York, NY. We used logistic regression and path analyses to examine direct and indirect effects of childhood sexual abuse on psychological distress and sexual risk behavior.

Results. We found a 15.8% (95% confidence interval = 12.3%, 19.2%) prevalence of childhood sexual abuse. Not having sex before age 16 years and having consensual sex before age 16 years did not differ from each other in predicting any of the outcomes of interest. Forced sex was associated with a significantly increased risk for all outcomes. A path analyses yielded direct effects of childhood sexual abuse and exposure to homophobia during childhood and during adulthood on psychological distress and indirect effects on risky sexual behavior. [...]

Childhood sexual experiences.

Consistent with previous findings, we subdivided childhood sexual experiences into 3 discrete categories: none, consensual, and forced sex.18 Participants were asked if they had had a sexual experience before age 16 years with someone 5 or more years older. If the participant answered no, he was categorized as not having sex; if he answered yes, he was asked if the sex was against his will. Those who answered no to the latter question were categorized as having consensual sex; those who answered yes were categorized as having forced sex. For this study, childhood sexual abuse was defined as forced sex ("against your will") before age 16 years with someone 5 or more years older. [...]

RESULTS

The prevalence of childhood sexual abuse among Latino gay and bisexual men was 15.8% (95% confidence interval [CI] = 12.3%, 19.2%). The prevalence of consensual sex before age 16 years was 34.8% (95% CI = 29.5%, 40.1%); the prevalence of not having sex before age 16 years was 49.4% (95% CI = 44.6%, 54.2%). The sample was primarily Spanish speaking, born outside of the United States, young (i.e., < 31 years), and of modest socioeconomic status (less than a college degree and $100-$500 weekly income). Childhood sexual experiences did not vary by any of the demographics.

Childhood Sexual Abuse, Risky Sex, and HIV Risk

We found no differences in psychological distress outcomes between those who reported not having sex before age 16 years compared with those who reported having consensual sex before age 16 years. Accordingly, we pooled both groups into a no childhood sexual abuse group and compared them with a childhood sexual abuse group composed of individuals who had experienced forced sex in childhood. The childhood sexual abuse group reported significantly more anxiety, depression, and suicidality than did the no childhood sexual abuse group (Table 1).

We found no differences between those who reported not having sex before age 16 years compared with those who reported having consensual sex before age 16 years. However, compared with the no childhood sexual abuse group, those who reported childhood sexual abuse were significantly more likely to report (1) sexual situations involving drug and or alcohol use, (2) having sex to escape from loneliness or depression, (3) having a nonmonogamous partner, and (4) difficulty maintaining an erection (Table 2).

Childhood sexual abuse (OR = 2.0; 95% CI = 1.1, 3.8) significantly predicted increased adult risky sexual behavior in unadjusted logistic regression analyses. As previously reported, [see note 25 in study] we found that psychological distress (OR = 1.7; 95% CI = 1.1, 2.5), exposure to homophobia during childhood (OR = 1.6; 95% CI = 1.3, 2.0), and risky sexual situations (OR = 3.0; 95% CI = 2.0, 4.3) significantly predicted increased adult risky sexual behavior in unadjusted logistic regression analyses.

source: Research 'Childhood Sexual Abuse and the Sociocultural Context of Sexual Risk Among Adult Latino Gay and Bisexual Men' by Sonya Grant Arreola (PhD, MPH), Torsten B. Neilands (PhD) & Rafael Díaz (PhD); www.ncbi.nlm.nih.gov/pmc/articles/PMC2865208/; American Journal of Public Health, 99(Suppl 2): S432-S438; October 2009