Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men.
Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men.
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DOI：
10.1007/s10508-015-0546-9
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发表时间：
2015-10
影响因子：
3.8
通讯作者：
O'Cleirigh C
中科院分区：
文献类型：
--
作者：
Boroughs MS;Valentine SE;Ironson GH;Shipherd JC;Safren SA;Taylor SW;Dale SK;Baker JS;Wilner JG;O'Cleirigh C
男男性行为者（MSM）是艾滋病毒风险最高的群体，占美国新感染者的大多数。据估计，男男性行为者中儿童期性虐待的比例高达46%。CSA与HIV风险增加和HIV性风险行为的可能性增加有关。本研究旨在探讨男男性行为者的CSA复杂性指标与心理健康、物质使用、性传播感染和HIV性风险的关系。有CSA病史的MSM（n = 162）接受了HIV预防疗效试验的筛查，完成了全面的心理社会评估。复杂的CSA经验的五个指标：CSA的家庭成员，CSA与渗透，CSA与身体伤害，CSA与强烈的恐惧，和第一次CSA在青春期。调整后的回归模型被用来确定CSA复杂性和结果之间的关系。家庭成员报告CSA的参与者当前酒精使用障碍的几率为2.6（OR：2.64：CI 1.24 - 5.63），物质使用障碍的几率高2倍（OR 2.1：CI 1.02 - 2.36），过去一年报告STI的几率高2.7倍（OR 2.7：CI 1.04 - 7.1）。CSA与渗透与当前PTSD（OR 3.17：CI 1.56 - 6.43），最近的HIV性风险行为（OR 2.7：CI 1.16 - 6.36）和更多的临时性伴侣（p = 0.02）的可能性增加相关。CSA伴身体伤害（OR 4.05：CI 1.9 - 8.7）和CSA伴强烈恐惧（OR 5.16：CI 2.5 - 10.7）均与当前PTSD的几率增加有关。青少年首次CSA与重度抑郁症的几率增加有关。这些研究结果表明，CSA，与一个或多个复杂性，创建模式的脆弱性男同性恋者，包括创伤后应激障碍，物质使用和性冒险，并建议需要详细评估CSA和开发综合艾滋病预防计划，解决心理健康和物质使用的合并症。
Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46%. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections (STIs) and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV-prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR: 2.64: CI 1.24 – 5.63), 2 times higher odds of substance use disorder (OR 2.1: CI 1.02 – 2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04 – 7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56 – 6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16 – 6.36) and a greater number of casual sexual partners (p = .02). Both CSA with Physical Injury (OR 4.05: CI 1.9 – 8.7) and CSA with Intense Fear (OR 5.16: CI 2.5 – 10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including PTSD, substance use, and sexual risk taking and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.