Adult Sexual Outcomes of Child Sexual Abuse Vary According to Relationship Status

This study tested a moderation model in which the association between child sexual abuse severity and negative sexual outcomes (i.e., sexual avoidance and compulsivity) differed as a function of relationships status (i.e., single, cohabiting, and married individuals). A sample of 1,033 adults completed self‐report questionnaires online, and 21.5% reported childhood sexual abuse. Path analyses indicated that child sexual abuse severity was associated with higher sexual compulsivity in single individuals, both higher sexual avoidance and compulsivity in cohabiting individuals, and higher sexual avoidance in married individuals. The moderation model was invariant across men and women. These results suggest that the time course of negative sexual outcomes associated with child sexual abuse may follow distinct patterns of expression according to relationship status.     

Sexual Dysfunction,Paraphilias and their Relationship to Childhood Abuse in Men who have Sex with Men

ABSTRACT

This study aimed to examine 1) the occurrence of sexual dysfunctions and paraphilias and 2) the relationship between childhood abuse and current sexual disorders in a MSM sample. Participants were MSM in the Midwest who completed baseline surveys prior to attending a sexual health seminar. Most men reported a sexual dysfunction or paraphilia. Thirty-nine percent of the sample reported childhood abuse. Results indicated childhood abuse was associated with a significant increased risk of male erectile disorder (OR = 1.83) and secondary sexual dysfunction (OR = 2.01). The intent of the study was to generate hypotheses to guide future research efforts.     

Co-Occurring Psychosocial Problems and Multiple Sexual Partners among Men Who Have Sex with Men in Shanghai,China: A Syndemic Approach

We aimed to apply syndemic theory to verify the association and reinforcing effects between psychosocial problems and multiple sexual partners (MSP) of men who have sex with men (MSM) in Shanghai, China. A cross-sectional study was conducted among 547 MSM in Shanghai, China using a face-to-face survey. Sociodemographic and psychosocial data were collected, as well as information on MSP and condomless anal sex. In the 6 months prior to the survey, 54.3% of the MSM sample had had MSP. Univariate analysis showed that self-esteem, depression, loneliness, sexual compulsivity, and involuntary subordination (IS) were associated with MSP. Sexual compulsivity (multivariate odds ratio [ORm] = 2.94, 95% CI = 1.76–4.91) and IS (ORm = 1.79, 95% CI = 1.14–2.81) remained significant in multivariate analysis. MSM with five or more psychosocial problems had greater odds of (adjusted odds ratios = 3.06, 95% CI = 1.49–6.25) having MSP in the previous 6 months than the non-syndemic group. Our findings provide preliminary confirmation of the additive relationship of syndemic psychosocial health conditions and MSP among MSM in Shanghai, China. An integrated intervention with special focus on sexual compulsivity and IS is needed.     

High Betrayal Adolescent Sexual Abuse and Nonsuicidal Self-Injury: The Role of Depersonalization in Emerging Adults

ABSTRACT

Adolescent sexual abuse can interfere with healthy development. Sexual abuse that is perpetrated by close other(s)—high betrayal—can be additionally harmful, with sexual abuse being linked with dissociation and nonsuicidal self-injury (NSSI). Depersonalization, a dissociative subtype characterized by disconnection between oneself and one’s body and/or thoughts, may further explain the role of dissociation in NSSI. The purpose of the current study was to: 1) isolate the impact of adolescent sexual abuse on NSSI; and 2) examine depersonalization as a pathway between high betrayal adolescent sexual abuse and NSSI. Participants (N = 192) were college students who completed online measures assessing sexual abuse, dissociation, and NSSI. While controlling for child sexual abuse and adult sexual abuse, adolescent sexual abuse predicted NSSI. Moreover, there was an indirect effect of high betrayal adolescent sexual abuse on NSSI through depersonalization, while controlling for child sexual abuse, adult sexual abuse, and medium betrayal (perpetrator: unclose other) adolescent sexual abuse. Findings from the current study have implications for relational cultural therapy as an evidence-informed treatment that highlights the relational harm of interpersonal trauma, while incorporating contextual elements, such as development of maladaptive coping strategies, into therapy.     

New Directions for Research Examining Sexual Trauma Histories of Gay Men

Summary

Research efforts have been unable to accurately examine the effect of childhood sexual trauma in the adult lives of gay men. Complications stemming from precise definitions of abuse, as well as the subjectivity inherent in the terms, make comprehensive research difficult. As abuse and traumatic events may sometimes be subtle and not involve overt violence, these more delicate events are often overlooked or unaccounted for. Further, because it is a complex endeavor to obtain accurate reporting from children, research efforts rely on the self-reports of adults remembering traumatic events. The symptomatology that results from trauma, including amnesia and dissociation, also affects the reliability of self-report. Additionally, gay men have been notably absent from sexual trauma research efforts for a variety of reasons. A research study which investigates childhood sexual trauma in the histories of adult gay men is discussed. Directions for future research efforts are suggested.     

Child Sexual Abuse and Adult Mental Health,Sexual Risk Behaviors,and Drinking Patterns Among Latino Men Who Have Sex With Men

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals’ likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.     

The Relationship Among Population Size,Requests for Bareback Sex,and HIV Serostatus in Men Who Have Sex With Men Using the Internet to Meet Sexual Partners

Recent research has indicated the use of the Internet to meet sexual partners among men who have sex with men (MSM) is increasing. This medium also serves as a major source for social and sexual networking among MSM who live in more rural areas. In addition, data suggest the use of the Internet to initiate sexual relationships among this population may increase the risk of transmission of sexually transmitted infections, including HIV. The purpose of this study was to examine differences between self-reported HIV serostatus and requests for condomless bareback (BB) sex among a sample of Florida MSM (n = 483) using a popular Internet sexual networking site to meet sexual partners. Specifically, these variables were assessed in relation to population size among the site's seven geographic regions within the state. Findings indicated an overall statistically significant relationship among requests for BB sex and self-reported HIV serostatus. However, there was not a significant relationship among these variables and geographic region. Thus, although previous data have emphasized the importance of different HIV prevention strategies among rural versus urban MSM, there may not be major differences in HIV serostatus and requests for unsafe sexual practices among these men who use the Internet to meet sexual partners in comparison to MSM in more populated areas.     

Parenting and child-caretaking among black men who have sex with men and associated sexual and reproductive health factors: a brief report

Abstract

The purpose of this exploratory study was to examine the prevalence of parenting and child-caretaking among a sample of black men who have sex with men (MSM), as well as associations between parenting roles and sexual and reproductive health (SRH) factors. Parenting and SRH data were derived from a survey of 199 black MSM. Nearly half of the sample reported being a father or father-figure (44.4%), almost a third indicated serving as caretaker of a child (29.1%), and one in five have a biological child (20.1%). Over half of the sample reported at least one of these three parenting/child-caretaking roles (52.5%). Two significant differences were observed for sexual health variables: men with biological children were significantly more likely to report using condoms inconsistently (55.0% vs. 35.7%, p = .026) and engaging in transactional sex work (36.8% vs. 21.0%, p = .041). Given the observed prevalence, parenting and child-caretaking among black MSM warrant further inquiry as factors that may influence SRH outcomes and care utilization. Services and interventions tailored to black MSM should consider these men’s potential roles and responsibilities as parents and caretakers of children.     

Electronic Media Access and Use for Sexuality and Sexual Health Education Among Men Who Have Sex With Men in Four Cities in Tanzania

Abstract

Background: Electronic media use is an important avenue for reaching stigmatized populations. We examined Internet access and use of sexually related electronic media among men who have sex with men (MSM) in 4 cities in Tanzania. Methods: A questionnaire was administered to 231 MSM in Dar es Salaam, Mwanza, Arusha, and Tanga regarding electronic media type, times of use, type of use and frequency of use of sexually-related media. Results: Mean age was 25.7?years, and 52% had completed high school. Half had access to the internet through personal electronic devices, a further quarter had access through work, 10% through friends’ devices, and only 2% had no access to the internet. Most frequently used electronic devices were personal computer followed by work smartphone, with work computer a close third. These patterns were consistent for both seeking other men for sex and finding sexual health information. All respondents had accessed sexual material electronically at some time. Substantial logged-in time was reported each week seeking/chatting with potential sexual partners (median?=?48 hr), looking at “porn” (median?=?24 hr), and searching for health information (median?=?7 hr). Over 98% indicated that they would use an anonymous/confidential online service for HIV and sexually transmitted infection testing. The majority (79%) had found sexual partners throughout the Internet in the last 24?hours, and 52% sought sexual health education online 2–3 times per week. Peak search time was evenings, increasing during weekends. Discussion: For Tanzanian MSM in cities, sexual electronic media use is high and includes work devices. Sexual health information seeking, and openness to electronic counseling and testing was almost universal. Electronic sites for sexual health access should be explored and evaluated.     

Associations Between Sexual Abuse and Negative Health Consequences Among High-Risk Men Who Have Sex with Men

This study evaluated whether a history of sexual abuse could differentiate negative health consequences among men who have sex with men (MSM; N = 148) enrolled in a risk counseling program. More than half (51.4%) reported an experience of sexual abuse. A history of sexual abuse was associated with increased psychological distress, increased rates of alcohol (AOR = 2.91; p <.01) and/or drug abuse (AOR = 2; p <.01) treatment, increased risk of housing instability (AOR = 2.13; p <.05), and increased risk for suicidality (AOR = 4.3; p <.001). Findings demonstrate that screening for sexual abuse may be useful in determining the service needs of high-risk MSM.     

“Sometimes You Just Have to Have a Lot of Bitter to Make It Sweet”: Substance Abuse and Partner Abuse in the Lives of HIV-Positive Men Who Have Sex with Men

Although links between partner abuse (PA) and substance abuse (SA) are well-documented in the literature, we know less about these relations among HIV-positive men who have sex with men (MSM). We conducted a qualitative study with this group (N = 28). Participants reported (1) social modeling of SA in childhood and in adult social networks, (2) initial use of substance to cope with child abuse and neglect, and (3) the reinforcement of problematic SA by experiences of PA, whereby SA led to PA, resulting in increased SA. Recommendations for clinicians working with HIV-positive MSM are discussed.     

Social,Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut,Lebanon

Objectives: We examined the social, relational and network determinants of condom use and HIV testing among men who have sex with men (MSM) in Beirut. Methods: Two-hundred thirteen men were recruited via respondent driven sampling and administered a survey. Results: Sixty-four percent reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% of participants had tested for HIV. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Conclusions: Multi-level social factors influence sexual health in MSM.     

The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high‐risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer‐assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one‐time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.     

Behavioral Escape Avoidance Coping in African-American Men Who Have Sex with Men

The purpose of this exploratory study was to investigate differences between African-American men who have sex with men (MSM) who use behavioral escape avoidance coping responses and those who do not. In particular, we investigated differences in the African-American MSM in our study on psychosocial factors such as internalized homonegativity, exploration phase sexual identity, and the importance of race/ethnicity identity to self-concept; and we investigated the association of these factors on the likelihood of the use of behavioral escape avoidance coping responses. Eighty-three African-American MSM completed our online assessment tool. Chi-square tests and modified Poisson regression were used to test our hypotheses. Our results revealed significant differences in the internalized homonegativity, exploration phase sexual identity, and in the importance of race/ethnicity identity to self-concept for the men in this study who endorsed behavioral escape avoidance coping responses compared to those who did not endorse behavioral escape avoidance coping responses.     

The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high-risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer-assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one-time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.     

Conscious Regulation of Sexual Arousal in Men

The goals of this study were to examine the effectiveness of emotional reappraisal in regulating male sexual arousal and to investigate a set of variables theoretically linked to sexual arousal regulation success. Participants first completed a series of online sexuality questionnaires. Subsequently, they were assessed for their success in regulating sexual arousal in the laboratory. Results showed that the ability to regulate emotion may cross emotional domains; those men best able to regulate sexual arousal were also the most skilled at regulating their level of amusement to humorous stimuli. Participants, on average, were somewhat able to regulate their physiological and cognitive sexual arousal, although there was a wide range of regulation success. Whereas some men were very adept at regulating their sexual arousal, others became more sexually aroused while trying to regulate. Age, sexual experience, and sexual compulsivity were unrelated to sexual arousal regulation. Conversely, sexual excitation, inhibition, and desire correlated with sexual arousal regulation success. Increased sexual excitation and desire were associated with poorer regulatory performance, whereas a propensity for sexual inhibition due to fear of performance consequences was related to regulatory success.     

Links between past abuse,suicide ideation,and sexual orientation among San Diego college students

The authors explored relationships among childhood abuse, suicidal ideation, and sexual orientation of 18- to 30-year-old students enrolled in 2 San Diego area colleges, using responses from anonymous questionnaires. Sixty percent of the 138 eligible respondents were women, and 22% were self-identified gay/bisexual individuals. Women were more likely than men to report at least 1 form of emotional abuse (odds ratio [OR] = 2.3; p =.02) and unwanted sexual touching (OR = 4.3; p = .0004). Lesbian/bisexual women were significantly more likely to report past suicidal ideation than were heterosexual women (OR = 3.7, p = .03). Gay/bisexual men were more likely to report unwanted sexual touching than were heterosexual men (OR = 5.1, p = .04), but the men did not report significantly higher rates of past suicide ideation or suicide attempts. Sexual orientation and a past history of child sexual, physical, and emotional abuse could be compounding risk factors for suicidal ideation among college students.     

Sexual Behavior Latent Classes Among Men Who Have Sex With Men: Associations With Sexually Transmitted Infections

Men who have sex with men (MSM) are at disproportionate risk of acquisition of sexually transmitted infections (STIs). We used latent class analysis (LCA) to examine patterns of sexual behavior among MSM and how those patterns are related to STIs. We examined patterns of sexual behavior using behavioral and clinical data from a cross-sectional study of 235 MSM who presented to an urban sexual health clinic for STI testing. Analyzed data were collected using a combination of interviewer- and self-administered surveys and electronic health records. We used LCA to identify underlying subgroups of men based on their sexual behavior, described the demographics of the latent classes, and examined the association between the latent classes and STI status. We identified three latent classes of sexual behavior: Unprotected Anal Intercourse (UAI) Only (67%), Partner Seekers (14%), and Multiple Behaviors (19%). Men in the Multiple Behaviors class had a 67% probability of being STI positive, followed by men in the UAI Only class (27%) and men in the Partner Seekers class (22%). Examining the intersection of a variety of sexual practices indicates particular subgroups of MSM have the highest probability of being STI positive.     

Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men

Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse history, symptoms of dissociation and trauma-related anxiety, borderline personality characteristics, substance use, and sexual risk behavior. Results indicated that men who have a history of childhood sexual abuse were more likely to: engage in high-risk sexual behavior (i.e., unprotected receptive anal intercourse), trade sex for money or drugs, report being HIV positive, and experience non-sexual relationship violence. Results of this study extend previous research to show that men who have sex with men and who have a history of child sexual abuse are more likely to be at high risk for HIV infection.     

Predictors of HIV Sexual Risk Behavior Among Men Who Have Sex with Men,Men Who Have Sex with Men and Women,and Transgender Women

ABSTRACT

Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations.