Understanding the Impact of Abuse on Men's Risk Behavior

了解虐待对男性危险行为的影响

• 批准号: 9182166
• 负责人: Ellen Benoit
• 金额: $ 23.94万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-31 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9182166
• 关键词: Accounting; Address; Adult; Age; Alcohol consumption; Alcohol or Other Drugs use; Bisexual; Caring; Child; Child Sexual Abuse; Childhood; Counseling; Drug usage; Emotional; Environmental Risk Factor; Ethnic group; Exploratory/Developmental Grant; Failure; Female; Fright; Gays; Gender; Gender Role; Goals; HIV; HIV/STD; Health; Health Services Accessibility; Healthcare; Homosexuals; Intervention; Interview; Latino; Lead; Link; Masculine; Measures; Mental Health; Mental Health Services; Methods; New York City; Outcome; Participant; Perception; Persons; Population; Prevalence; Prevention; Provider; Public Health; Race; Readiness; Recording of previous events; Research; Research Personnel; Risk Behaviors; Role; Same-sex; Services; Sex Behavior; Sexual abuse; Sexuality; Shame; Socialization; Societies; Source; Stress; Time; Training; Trauma; Treatment Protocols; Variant; Woman; adverse outcome; base; boys; experience; health service use; high risk sexual behavior; improved; male; meetings; men; men who have sex with men; men who have sex with men and women; outreach; perpetrators; pressure; psychologic; public health relevance; revictimization; same sex behavior; sexual encounter; sexual minority; sexual relationship; social; social stigma; substance abuse treatment; substance misuse

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.

抽象的 黑人和拉丁裔性少数男性遭受童年性虐待 (CSA) 的比例可能高于他们的男性 白人同行。性少数男性的 CSA 史与不良后果相关，包括 药物滥用、心理健康状况不佳、再次受害和高风险性行为。因为黑人和拉丁裔 文化强调男性气质的传统形式，男性可能面临压力，否认某些童年性行为 由于害怕被视为同性恋或受害者而遭受虐待。大多数 CSA 研究都与性有关 少数族裔男性依赖定量衡量标准，而这些衡量标准往往排除了考虑文化差异的因素 形成性的性经历是可以理解的，并且基于不一致和/或过度限制性的定义 的虐待。此外，有限的评估方法可能会导致无法检测到一些虐待经历（例如， 那些涉及女性施暴者的行为），如果不加以识别，可能会产生有害的健康后果。 这些问题表明需要扩大 CSA 的概念，以承认男性的评价和 对他们童年性经历（CSE）的解释。为此，我们将进行混合方法访谈 关于纽约市 40 名黑人和 40 名拉丁裔性少数男性的全面性教育。 研究人员呼吁采取干预措施，将 CSA 历史纳入药物滥用治疗和 男男性行为者 (MSM) 和男男性行为者和女同性恋者使用的其他医疗服务 （MSMW）。然而，这些人可能不愿意获得此类服务，因为担心受到耻辱、暴露自己的身份。 同性行为、一般提供者不信任以及认为提供者缺乏性培训的看法。更远， 服务提供者可能没有能力认识到安全创伤知情护理的必要性，特别是因为 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 家服务机构 性史是否以及如何在治疗和其他医疗保健环境中得到解决。 我们提出以下具体目标：1）调查对儿童性经历的评估 黑人和拉丁裔 MSM 和 MSMW，并使用既定标准评估这些经验 定义性虐待； 2）检查与性别认同相关的童年性经历的评估 形成、成人性关系和行为、隐瞒同性行为、酗酒和吸毒、 黑人和拉丁裔 MSM 的心理和情感功能以及男性气质的文化意识形态 多城市MW； 3) 研究黑人和拉丁裔男男性行为者和男男性行为者以及相关服务提供商的观点： 了解性史在治疗和咨询环境中的作用和必要性； b) 确定 服务提供者在治疗和咨询环境中解决儿童性经历的准备情况。 这项形成性研究将为评估性虐待历史并将其纳入可测试的方法提供信息 有此类病史的男性使用的药物滥用治疗和其他健康和心理健康服务。