Interaction of abuse, PTSD, depression on men's sex risk

虐待、创伤后应激障碍、抑郁对男性性风险的相互作用

• 批准号: 7127725
• 负责人: WILLIAM C HOLMES
• 金额: $ 48.15万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-29 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7127725
• 关键词: AIDS education /prevention; HIV infections; behavioral /social science research tag; bisexual; child abuse; clinical research; comorbidity; data collection methodology /evaluation; depression; disease /disorder proneness /risk; high risk behavior /lifestyle; homosexuals; human subject; interview; male; mathematical model; posttraumatic stress disorder; psychopathology; questionnaires; safe sex /sex abstinence; sex abuse; sex behavior; sex behavior disorder

DESCRIPTION (provided by applicant): More men with than men without childhood sexual abuse (CSA) histories report sexual behavior that has high risk for HIV transmission. Since 1-in-6 to 1-in-14 men report histories of childhood sexual abuse (CSA), the population of men with CSA histories is a numerous and suitable one for research that seeks to understand evolving sexual risk behavior patterns that have HIV infection risk. Such an effort is critical at a time when the pattern of long-term declines in gonorrhea and syphilis rates have reversed due to rate increases in men. Our specific interests in the current study of male sexual risk behavior patterns emanate from preliminary findings of the principal investigator. This work has indicated that co-morbid posttraumatic stress disorder (PTSD) and depression acts as both a mediator and a moderator of the association between CSA and sexual risk behavior. The subgroup with CSA/PTSD/depression had the highest lifetime sexual partners (mean, 54.3). To understand these findings better, we have evolved for use in men a model originally developed to describe the mediating pathway from CSA to adult risk in women. We propose further study of this newly identified role of co-morbid PTSD/depression on men's HIV-related sexual risk behavior by adjusting more fully for potentially confounding/effect-modifying variables and by doing so in analyses of lifetime and current sexual behavior assessments. We also will test the model we have evolved to explain the mediating/moderating pathway between CSA and lifetime sexual risk behavior in men by employing structural equation modeling (SEM) to assess relationships between CSA and resilience, psychopathology, sexual maladjustment, sexual networks, and sexual activity that have HIV infection risk. We propose a cross-sectional, random-digit-dial (HDD) survey of 1,200 men from high AIDS incidence areas of Philadelphia County; 300 of these will be oversampled heterosexually- and homosexually-identifying men who have sex with men (MSM) recruited for exploratory analyses of whether the noted SEM is applicable to MSM as well as to men who only have (had) sex with women. Study results will inform construction and allow testing of a developing, integrative model for men that identifies factors that mediate and moderate linkages between CSA and HIV-related sexual risk. From this model, multidimensional HIV risk reduction interventions can be built.

描述（由申请人提供）：有儿童期性虐待（CSA）史的男性比没有儿童期性虐待史的男性报告的性行为具有高艾滋病毒传播风险。由于六分之一至十四分之一的男性报告有儿童期性虐待（CSA）的历史，因此有CSA历史的男性人口数量众多，适合用于研究，以了解具有艾滋病毒感染风险的性风险行为模式的演变。在淋病和梅毒发病率长期下降的模式由于男性发病率上升而逆转的时候，这样的努力至关重要。我们对目前男性性风险行为模式研究的具体兴趣来自主要研究者的初步发现。这项工作表明，共病的创伤后应激障碍（PTSD）和抑郁症作为一个调解人和调节CSA和性风险行为之间的关联。患有CSA/创伤后应激障碍/抑郁症的亚组拥有最多的终生性伴侣（平均54.3）。为了更好地理解这些发现，我们已经发展了一个用于男性的模型，该模型最初是为了描述从CSA到女性成年风险的介导途径。 我们建议通过更充分地调整潜在的混杂/影响修改变量，并通过分析终身和当前的性行为评估，进一步研究这种新发现的共病PTSD/抑郁症对男性HIV相关性风险行为的作用。我们还将测试我们已经发展到解释CSA和终身性风险行为之间的中介/调节途径的模型，通过采用结构方程模型（SEM）来评估CSA和弹性，精神病理学，性适应不良，性网络和有HIV感染风险的性活动之间的关系。我们提出了一个横截面，随机数字拨号（HDD）调查的1,200名男子从艾滋病高发区的费城县，其中300人将被过度抽样的异性恋和同性恋识别男性与男性发生性关系（MSM）招募的探索性分析，是否指出的SEM是适用于MSM以及男性谁只（有）与女性发生性关系。 研究结果将告知建设，并允许测试一个发展中的，综合模型的男子，确定因素，调解和中度CSA和艾滋病毒相关的性风险之间的联系。根据这一模式，可以建立多层面的减少艾滋病毒风险干预措施。