History of Childhood Sexual Abuse and Unsafe Anal Intercourse in a Six-City Study of HIV-Positive MSM

Among a population of HIV-positive men who reported unsafe anal intercourse with other men in the preceding year, the authors assessed rates of childhood sexual abuse and its demographic and mental health correlates. The researchers conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men (MSM), who were enrolled in the "Positive Connections" intervention.

Forty-seven percent of participants reported childhood sexual abuse, with 32 percent reporting the frequency of abuse was sometimes or often. The MSM reporting abuse were more likely to be Latino (odds ratio [OR]: 2.6; 95 percent confidence interval [CI]=1.6, 4.2; P<.001) or African American (OR=1.8; 95 percent CI=1.2, 2.7; P=.005) than white. Among MSM reporting abuse, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR]=1.3; P<.001) and unsafe anal intercourse (often, RR=1.5; sometimes, RR=2.0; P<.001) compared to men who were not abused.

"History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color," the authors concluded. "Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections."

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