Understanding the Impact of Abuse on Men's Risk Behavior

摘要 黑人和拉丁裔性少数群体的男性可能有更高的儿童性虐待（CSA）率比他们的 白色对应物。性少数男性的CSA病史与不良后果有关，包括 滥用药物、精神健康状况不佳、再次受害和高风险性行为。因为黑人和拉丁裔 文化强调传统形式的男子气概，男人可能会在压力下否认某些童年性行为， 因为害怕被视为同性恋或受害者而遭受虐待。大多数CSA研究与性 少数民族男性依赖于数量的措施，往往排除考虑文化差异， 形成性的性经验是可以理解的，并且是基于不一致和/或过度限制的定义 虐待此外，有限的评估方法可能导致无法发现一些虐待经历（例如， 涉及女性施暴者的暴力行为），如果不加以承认，可能会对健康造成有害后果。 这些问题表明，有必要扩大自我评估的概念，承认男子的评估， 儿童期性经验（CSE）为此，我们将进行混合方法的采访， 在纽约市与40名黑人和40名拉丁裔性少数群体男子进行了CSE的调查。 研究人员呼吁采取干预措施，将CSA历史纳入药物滥用治疗， 男男性行为者和男男性行为者使用的其他保健服务 （MSMW）。然而，这些男子可能不愿意获得这种服务，因为他们害怕耻辱，暴露他们的身份， 同性行为，一般供应商的不信任，以及供应商缺乏性培训的看法。此外，本发明还 服务提供者可能没有能力认识到需要安全的创伤知情护理，特别是因为它 与性虐待有关。为了了解提供者的经验和治疗方案，我们将采访30名服务人员， 提供者关于性史是否以及如何在治疗和其他卫生保健环境中处理。 我们提出以下具体目标：1）调查儿童期性经验的评价 在黑人和拉丁裔男男性行为者和男男性工作者中，并使用既定的标准评估这些经验， 性虐待的定义; 2）检查儿童期性经历的评估与性认同的关系 形成，成年人的性关系和行为，同性行为的隐瞒，酒精和毒品的使用， 心理和情感功能，以及黑人和拉丁美洲男男性行为者的男性气概的文化意识形态， 3）研究黑人和拉丁裔男男性接触者和男男性接触者以及相关服务提供者的观点，以：a） 了解性史在治疗和咨询环境中的作用，并需要将其包括在内;以及B）确定 服务提供者在治疗和咨询环境中处理儿童性经历的准备情况。 这项形成性研究将为评估和将性虐待历史纳入可测试的方法提供信息。 药物滥用治疗和其他健康和心理健康服务。

ABSTRACT Black and Latino sexual minority men are likely to have higher rates of childhood sexual abuse (CSA) than their White counterparts. CSA history among sexual minority men is associated with adverse consequences including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Because Black and Latino cultures stress traditional forms of masculinity, men may be under pressure to deny certain childhood sexual experiences as abusive out of fear of being perceived as gay or as victims. Most CSA research with sexual minority men relies on quantitative measures that often preclude consideration of cultural variations in how formative sexual experiences are understood, and are based on inconsistent and/or overly restrictive definitions of abuse. Moreover, limited assessment methods may result in failure to detect some abusive experiences (e.g., those involving female perpetrators), which can have harmful health consequences if they remain unrecognized. These issues indicate a need to broaden the conceptualization of CSA to recognize men's appraisals and interpretations of their childhood sexual experiences (CSE). To that end, we will conduct mixed-methods interviews regarding CSE with 40 Black and 40 Latino sexual minority men in New York City. Researchers are calling for interventions that incorporate CSA history into substance abuse treatment and other health services used by men who have sex with men (MSM) and men who have sex with men and women (MSMW). However, these men may be reluctant to access such services for fear of stigma, exposure of their same-sex behavior, general provider mistrust, and perceptions that providers lack training in sexuality. Further, service providers may not be equipped to recognize the need for safe trauma-informed care, particularly as it relates to sexual abuse. To understand provider experiences and treatment protocols, we will interview 30 service providers regarding whether and how sexual histories are addressed in treatment and other health care settings. We propose the following specific aims: 1) to investigate appraisals of childhood sexual experiences among Black and Latino MSM and MSMW and to evaluate these experiences using established criteria for defining sexual abuse; 2) to examine appraisals of childhood sexual experiences relative to sexual identify formation, adult sexual relationships and behaviors, concealment of same-sex behavior, alcohol and drug use, psychological and emotional functioning, and cultural ideologies of masculinity among Black and Latino MSM and MSMW; 3) to examine perspectives of Black and Latino MSM and MSMW and relevant service providers to: a) understand the role of, and need to include, sexual history in treatment and counseling settings; and b) determine service providers' preparedness to address childhood sexual experiences in treatment and counseling settings. This formative research will inform testable approaches to assessing and incorporating sexual abuse history into substance abuse treatment and other health and mental health services used by men with such histories.