Childhood Sexual Abuse and HIV Risk Among Men Who Have Sex with Men: Initial Test of a Conceptual Model

Childhood sexual abuse has been associated with HIV transmission risk behavior in men who have sex with men. This study examined an adapted model that was originally developed to explain the relationship between childhood sexual abuse and HIV risk behavior among women 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, symptoms of dissociation, trauma-related anxiety, borderline personality characteristics, hopelessness, substance use, and sexual risk behavior. A latent variable partial least squares analysis was conducted to test the interrelationships between childhood sexual abuse, exchanging sex for money or drugs, emotional disturbances, drug use, substance use in the context of sexual behavior, and sexual risk behavior. The model fit the data well and accounted for 10% of the total variance in sexual risk behavior. History of childhood sexual abuse predicted exchanging sex for money or drugs and this relationship was partly accounted for by active drug use. Substance use proximal to sexual behavior also emerged as a key factor in predicting sexual risk behavior. Findings from this study, therefore, indicate a direct association between history of child sexual abuse and high risk for HIV infection related to engaging in sex trade.