Sexually Abused Men Likely To Engage In Unsafe Sex

9 May 2001
Sexually Abused Men Likely To Engage In Unsafe Sex

Men who have sex with men (MSM) who are victims of childhood sexual abuse are more likely to engage in risky sexual behavior than other MSMs, say researchers from UCSF's Center for AIDS Prevention (CAPS).

The study, published in the April issue of Child Abuse & Neglect, found that about one fifth (20.6%) of all MSMs experienced childhood sexual abuse--a rate that is higher than prevalence estimates for the general male population. These men's early sexual victimization experiences typically involved physical force, penetrative sex, and were highly distressing. Researchers found that greater severity of childhood abuse (more incidents) was associated with higher rates of risky sexual behavior. Findings were similar using two different definitions of risky sexual behavior (unprotected anal intercourse with a non-primary partner; unprotected anal intercourse with a male whose HIV status was different from their own). As further evidence of their greater sexual risk-taking, those reporting childhood sexual abuse were more likely to be HIV-positive (24% vs. 14%).

To understand better the linkages between childhood sexual abuse and current sexual risk, the researchers examined other behaviors that are both associated with sexual risk taking and with childhood sexual abuse. The study found that the men who had been victimized had higher rates of sex under the influence of alcohol/drugs, "one-night stands," and intimate partner violence, the researchers said. The current risk behavior of sexually abused men could be related to these variables, which were also linked to other measures of disturbed family functioning (e.g., childhood physical abuse, parental substance abuse).

"These findings clearly indicate that there is a need to consider childhood sexual abuse in developing and delivering HIV prevention interventions. Messages that emphasize the avoidance of 'sex under the influence' may not be effective for those men whose use of substances may be a form of coping with the disturbing aftermath of early sexual traumatization. Work can be done to identify prevention strategies that consider the after-effects of childhood sexual abuse," said lead author, Jay Paul, PhD, a specialist in the division of medicine at UCSF's Center for AIDS Prevention Studies.

"In addition, given the extent to which this is a problem among MSM, community services should be reviewed to ensure that appropriate referrals are offered at points where these men may contact mental health, substance abuse, social services and medical services. The multiple health-related negative consequences of childhood sexual abuse emphasize the need to give this issue appropriate attention," said Paul.