Childhood sexual experiences with an older partner among men who have sex with men in Buenos Aires,Argentina

This study sought to describe childhood sexual experiences with older partners (CSEOP) among men who have sex with men (MSM) in Buenos Aires, Argentina. MSM were recruited through respondent driven sampling. They responded to a computer administered self-interview with questions on CSEOP, operationalized as manual, oral, genital, or anal contact prior to age 13 with a partner at least 4 years older. Of the 500 respondents, only 25% identified as gay. Eighteen percent of the respondents reported CSEOP, the majority of whom did not feel they were hurt by the experience and did not consider it to be childhood sexual abuse (CSA). Over two-thirds of MSM who reported CSEOP said that their older partner was a female. Only 4% of those with a female partner felt their experience was CSA compared to 44% of those who had a male partner. Among all men reporting CSEOP, those who felt sexually abused were more likely to have been physically forced or threatened, physically hurt, and emotionally hurt than those who did not feel sexually abused. Having CSEOP, being hurt by the experiences, and perceiving the experiences as sexual abuse were not associated with current HIV sexual risk or substance use behavior. In this sample of MSM in Argentina, a substantial minority reported CSEOP. Those who felt they had been sexually abused were much more likely to have had an older male partner than an older female partner, and were more likely to report having been physically forced and threatened by their older partner.     

Higher prevalence of childhood sexual abuse among Latino men who have sex with men than non-Latino men who have sex with men: data from the Urban Men's Health Study

OBJECTIVE: The prevalence of childhood sexual abuse among Latino adult men who have sex with men who live in the US was estimated because a history of childhood sexual abuse increases HIV sexual risk behaviors and other negative health outcomes in adulthood. METHOD: The Urban Men's Health Study is a random-digit telephone probability survey of 2881 adult men who have sex with men (MSM) aged 18 years or older residing in San Francisco, New York, Los Angeles, and Chicago. Self-reported history of childhood sexual abuse was the main outcome measure gathered from 2692 MSM. RESULTS: A significantly higher proportion of Latino MSM reported sexual abuse before age 13 (22%) than did non-Latino MSM (11%). CONCLUSIONS: Latino MSM are twice as likely to report a history of childhood sexual abuse than are non-Latino MSM. Given the association between childhood sexual abuse and increased risk for HIV and other negative health outcomes, health providers must remain vigilant to the possibility of childhood sexual abuse histories among their Latino patients.     

Self-reported childhood and adolescent sexual abuse among adult homosexual bisexual men.

From May 1989 through April 1990, 1,001 adult homosexual and bisexual men attending sexually transmitted disease clinics were interviewed regarding potentially abusive sexual contacts during childhood and adolescence. Thirty-seven percent of participants reported they had been encouraged or forced to have sexual contact before age 19 with an older or more powerful partner; 94% occurred with men. Median age of the participant at first contact was 10; median age difference between partners was 11 years. Fifty-one percent involved use of force; 33% involved anal sex. Black and Hispanic men were more likely than white men to report such sexual contact. Using developmentally-based criteria to define sexual abuse, 93% of participants reporting sexual contact with an older or more powerful partner were classified as sexually abused. Our data suggest the risk of sexual abuse may be high among some male youth and increased attention should be devoted to prevention as well as early identification and treatment.     

Childhood sexual experiences among substance-using non-gay identified Black men who have sex with men and women

This study explored potential variations in childhood sexual abuse (CSA) by examining qualitative accounts of first sexual experiences among non-disclosing, non-gay identified Black men who have sex with men and women (MSMW). We analyzed data from semi-structured qualitative interviews with 33 MSMW who described first sexual experiences with male and female partners. Thematic analysis revealed four patterns of first sexual experiences including: unwanted sexual experiences with a male or female consistent with definitions of childhood sexual abuse; consensual sex with an older male or female; bodily exploration with another male or female child; and consensual sex with a peer-age female. Most of the experiences described by participants as consensual with an older male or female, however, met criteria for childhood sexual abuse found in the extant literature. Several men discussed childhood sexual experiences (CSE) relative to their experiences with alcohol, drugs, and same-sex behavior as adults. Findings suggest that the relationship between CSE and risk-taking behavior may be shaped by whether men perceive their experiences as abusive or consensual, and have implications for researchers, treatment providers and counselors.     

Posttraumatic cognitions,childhood sexual abuse characteristics,and posttraumatic stress disorder in men who have sex with men

BackgroundHigh rates of experience of childhood sexual abuse (CSA) among in men who have sex with men (MSM) place this population at increased risk for posttraumatic stress disorder (PTSD).ObjectiveThis study explores how specific characteristics of CSA relate to posttraumatic cognitions (PTCs) and explores the role that specific PTCs play in the relationship between CSA and PTSD in MSM.MethodsTwo-hundred and ninety MSM completed a CSA interview, the Davidson Trauma Scale, and the Posttraumatic Cognitions Inventory.ResultsControlling for sociodemographic factors, CSA involving physical injury and CSA with intense fear were associated with higher levels of PTCs about the self and world, but not with self-blame. We did not find significant associations for CSA involving a family member, CSA with penetration, or duration or frequency of CSA with any subscale on the PTCI. Experiencing CSA for the first time during adolescence was associated with higher self-blame. Analyses revealed that physical injury and intense fear each had indirect effects on PTSD symptoms through negative cognitions about the self and world. First CSA episode during adolescence had an indirect effect on PTSD symptoms through self-blame. CSAs accounted for 16.7% and PTCs accounted for 31.7% of the variance in PTSD, underlining the importance of PTCs.ConclusionsAssessing for physical injury, intense fear, and age at first CSA are particularly relevant to PTCs and of critical importance to advancing assessment and treatment strategies for PTSD in MSM.     

Mediation effects of problem drinking and marijuana use on HIV sexual risk behaviors among childhood sexually abused South African heterosexual men

HIV/AIDS prevalence in South Africa is one of the highest in the world with heterosexual, transmission predominantly promoting the epidemic. The goal of this study is to examine whether, marijuana use and problem drinking mediate the relationship between histories of childhood sexual, abuse (CSA) and HIV risk behaviors among heterosexual men. Participants were 1181 Black men aged, 18–45 from randomly selected neighborhoods in Eastern Cape Province, South Africa. Audio computer assisted, self-interviewing was used to assess self-reported childhood sexual abuse, problem drinking, and marijuana (dagga) use, and HIV sexual transmission behavior with steady and casual partners. Data were analyzed using multiple meditational modeling. There was more support for problem, drinking than marijuana use as a mediator. Findings suggest that problem drinking and marijuana use, mediate HIV sexual risk behaviors in men with histories of CSA. Focusing on men with histories of CSA, and their use of marijuana and alcohol may be particularly useful for designing strategies to reduce, HIV sexual transmission in South Africa.     

Men's self-definitions of abusive childhood sexual experiences, and potentially related risky behavioral and psychiatric outcomes

OBJECTIVES: To estimate how many heterosexual and gay/bisexual men self-define abusive childhood sexual experiences (CSEs) to be childhood sexual abuse (CSA) and to assess whether CSA self-definition is associated with risky behavioral and psychiatric outcomes in adulthood. METHODS: In Philadelphia County, 197 (66%) of 298 recruited men participated in a telephone survey. They were screened for CSEs and then asked if they self-defined abusive CSEs to be CSA; they also were asked about risk behavior histories and post-traumatic stress disorder (PTSD) and depression symptoms. RESULTS: Of 43 (22%) participants with abusive CSEs, 35% did not and 65% did self-define abusive CSEs to be CSA ("Non-Definers" and "Definers," respectively). Heterosexual and gay/bisexual subgroups' CSA self-definition rates did not significantly differ. When self-definition subgroups were compared to those without CSEs ("No-CSEs"), Non-Definers had lower perceived parental care (p=.007) and fewer siblings (p=.03), Definers had more Hispanics and fewer African Americans (p=.04), and No-CSEs had fewer gay/bisexual men (p=.002) and fewer reports of physical abuse histories (p=.02) than comparison groups. Non-Definers reported more sex under the influence (p=.001) and a higher mean number of all lifetime sex partners (p=.004) as well as (only) female sex partners (p=.05). More Non-Definers than Definers reported having experienced penetrative sex as part of their CSA (83% vs. 35%, p=.006). Different explanations about self-definition were provided by subgroups. CONCLUSIONS: Many men with abusive CSEs do not self-define these CSEs to be CSA, though not in a way that differs by sexual identity. The process by which men self-define their abusive CSEs to be CSA or not appears to be associated not only with self-explanations that differ by self-definition subgroup, but also with behavioral outcomes that impart risk to Non-Definers.     

Childhood sexual abuse, adolescent sexual coercion and sexually transmitted infection acquisition among homeless female adolescents

OBJECTIVE: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents. METHOD: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and recent history of sexual coercion were used to predict physiologically confirmed STI acquisition over the subsequent 6 months. RESULTS: About 38% of all girls reported a history of childhood sexual abuse (CSA). Girls with a history of CSA were more likely to report recent sexual coercion. In turn, sexual coercion in the last three months was significantly associated with a higher number of sexual partners (but not with a greater frequency of intercourse or with lower rates of condom use). Number of sexual partners significantly predicted the future acquisition of an STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors in homeless adolescent females may need to consider the impact of CSA, particularly on the number of sexual partners during adolescence. However, it also should be noted that engagement in intercourse often results from coercion and is not voluntary in this population.     

Framing gender identity and sexual orientation: media influence on young men who have sex with men’s health

Sex education takes place in a wide range of contexts including through the media. Media use among young men who have sex with men is high and gender identity and sexual orientation are topics often integrated into today’s media. Little is known about young men who have sex with men’s perceptions of how the media frames messages about gender identity and sexual orientation and the implications these messages have on HIV prevention. A greater understanding of young men who have sex with men’s perceptions of media framing about gender identity and sexual orientation is needed to ensure prevention efforts reach those most impacted by HIV. Focus groups were conducted with forty-two African American men who have sex with men, aged 18–21, living in the Southeastern USA. Thematic analysis revealed that participants reported using the Internet and television to access gender identity and sexual orientation information. Participants felt that the media’s framing of gender identity and sexual orientation only worsened HIV-related stigma and discrimination. Findings illustrate the important role that media can play in educating about gender identity and sexual orientation and the implications this framing has for HIV prevention.     

A meta-analysis of the relationship of child sexual abuse to HIV risk behavior among women

OBJECTIVE: This study is a meta-analysis of the literature exploring the relationship between child sexual abuse (CSA) and HIV risk behavior among women. Four outcome variables were tested: unprotected sex; sex with multiple partners; sex trading; and adult sexual revictimization. METHOD: Forty-six studies met the inclusion criteria and were included in the analysis, and separate meta-analyses were performed for each of the four dependent variables described above. RESULTS: Using the correlation coefficient r as an effect size estimate, results indicate an average effect size of .05 for the unprotected sex meta-analysis (N = 16 studies), .13 for the sex with multiple partners meta-analysis (N = 23 studies), .12 for the sex trading meta-analysis (N = 23 studies), and .17 for the adult sexual revictimization meta-analysis (N = 21 studies). We conducted a test of three potential moderator variables (source of sample, definition of CSA based on type of contact, and definition of CSA based on maximum age of victim). Results did not support the hypothesis that these three variables explain a significant amount of variability in effect sizes with one exception: Studies that define CSA more broadly to include adolescent victims (e.g., victims up to 17 years of age) had larger and more homogenous effect sizes for the sex trading meta-analysis than those that defined CSA as having occurred at younger ages. CONCLUSIONS: These findings suggest a small positive relationship between CSA and subsequent HIV risk behavior among women that varies as a function of how CSA and HIV risk behavior are operationalized.     

Early life emotional neglect and HIV risk taking among men using the Internet to find other men for unprotected sex

Purpose: Using a Syndemics Theory conceptual model, this study examines the relationship between emotional neglect experiences during childhood and/or adolescence and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. Methods: The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. Results: Emotional neglect was highly prevalent among the men participating in this study. Emotional neglect experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. Conclusions: Childhood experiences with emotional neglect are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, emotional neglect appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes.     

Is child sexual abuse declining? Evidence from a population-based survey of men and women in Australia

OBJECTIVE: Substantiated cases of child sexual abuse (CSA) in the United States have declined significantly over the past decade. This may, or may not, reflect change in the underlying rate in the general population. This study examines age-cohort differences in the prevalence of self-reported CSA experiences of men and women aged 18-59 years in a community-based sample from a comparable western nation. METHOD: In April 2000, we completed a cross-sectional, telephone-based survey of a randomly selected national sample of men and women in Australia. Volunteers (876 males, 908 females) answered a range of questions about health status and sexuality, including unwanted sexual experiences before the age of 16 years. Of selected adults with publicly-listed telephone numbers, 61% agreed to participate. There were few differences between the volunteers and the Australian population on demographic variables and health indicators. RESULTS: Non-penetrative CSA was twice as common among women (33.6%) than men (15.9%). Approximately 12% of women and 4% of men reported unwanted penetrative experiences. CSA was reported significantly less often by younger males, with a linear decline from the oldest to youngest men. Among all females who had intercourse before age 16, older women were much more likely than younger women to say they were an unwilling partner on the first occasion. If first intercourse occurred at age 16 or later, there were no age-cohort differences in risk of first-time abuse. Self-reported "openness" and "comfort" during the telephone interviews was not systematically related to prevalence of CSA. CONCLUSION: These population-based findings provide evidence of a decline in the underlying rate of CSA in Australia. Although every measure of CSA inevitably is flawed to some extent, these trends in self-report complement official statistics that show substantial decline in recent years.     

Childhood sexual abuse by representatives of the Roman Catholic Church: A prevalence estimate among the Dutch population

Estimates of the extent of childhood sexual abuse (CSA) within in the Roman Catholic Church (RCC) in the general population are difficult to find. The independent Commission of Inquiry into sexual abuse of minors in the RCC in the Netherlands collected population-based data to estimate its prevalence. A large random online population sample was surveyed using a two-phase stratified sampling procedure. In Phase 1, 34,267 subjects aged 40 years and older were screened for childhood exposure to sexual abuse by non-family members, a history of institutionalization and a Roman Catholic upbringing. In Phase 2, a stratified subset of 2,462 subjects was assessed to obtain more detailed target information about sexual abuse reports within the RCC. We employed multiple imputation for the estimation of RCC CSA in the original Phase 1 sample. The prevalence of non-familial CSA in general (14.0%) was higher among women (17.2%) than among men (10.6%). The prevalence of CSA within the Dutch RCC (1.7%) was higher among men (2.7%) than among women (0.7%). As expected, older subjects reported more often CSA in the RCC than their younger counterparts. Respondents who stayed for some time in RCC run institutions for education or child protection had a higher risk to report sexual abuse. Although sexual abuse of minors by representatives of the RCC was a structural problem during a period that the Church was highly influential in the Netherlands, the estimated prevalence of the phenomenon is only a fraction of the prevalence rate of non-familial CSA.     

Masculine norms,disclosure, and childhood adversities predict long-term mental distress among men with histories of child sexual abuse

Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N = 487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables—use of physical force by the abuser—was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed.     

Self-defining as sexually abused and adult sexual risk behavior: results from a cross-sectional survey of women attending an STD clinic

Objective

Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as having experienced CSA despite meeting objective criteria that CSA occurred. This study sought to determine whether individuals who met research criteria for CSA and who self-defined as sexually abused differed on traumagenic dynamics constructs and current sexual risk behavior from individuals who met research criteria for CSA and who did not self-define as sexually abused.

Methods

Participants were 481 women recruited from a publicly funded STD clinic. Participants completed a computerized survey assessing childhood sexual experiences and adult sexual risk behavior.

Results

Of the total sample, 206 (43%) met research criteria for CSA. Of the women meeting research criteria for CSA, 142 (69%) self-defined as sexually abused. Women who met research criteria for CSA reported more traumatic sexualization, more trust of a partner, more powerlessness, less sexual guilt, more episodes of unprotected sex, more sex partners, and greater likelihood of sex trading, compared to women who did not meet research criteria for CSA. Among women meeting research criteria, those who self-defined as sexually abused did not differ from those who did not self-define on any of the traumagenic dynamics constructs or on current sexual risk behavior, controlling for CSA characteristics.

Conclusions

Individuals who were sexually abused as children by behavioral research criteria are at risk for engaging in sexual risk behavior as adults, regardless of whether or not they perceive the experience to be CSA. Future research is needed to understand how non-definers perceive these childhood sexual experiences.     

Child sexual abuse in China: a study of adolescents in four provinces

OBJECTIVE: Little is known about Child Sexual Abuse (CSA) in Chinese societies. This study examined CSA experiences and associations with demographic factors, self-reported health and risky behaviors among senior high school students in four provinces in central and northern China. METHOD: Students in four schools in Hubei, Henan, Hebei, and Beijing provinces participated in an anonymous, self-completed questionnaire survey. From a total enrollment of 3,261 students in the target classes in years 11 and 12, 2,300 (70.5%) returned valid questionnaires. Mean age was 17.2 years. The questionnaire was adapted from prior CSA research in Australia and utilized standard scales for depression, self-esteem, and youth risk behavior. RESULTS: Prevalence of any unwanted sexual experience before the age of 16 years was higher among females (16.7%) than males (10.5%). Sexual penetration was rarely reported (1%), while 7% reported at least one type of physical contact abuse (female 8.9%, male 5.0%). Risk of any CSA was not associated with the existence of siblings (one-child vs. two- or more child families), rural/urban residence during childhood, or parental education. Males and females with CSA were more depressed and suicidal, and drank alcohol more often, than unaffected adolescents. Contact CSA was strongly associated with sexual intercourse (ever) for both males and females. Females with CSA were more likely than others to engage in anorexic and bulimic behaviors, while males with CSA were often involved in violence. CONCLUSION: Social norms for consensual sexual experiences differ between Eastern and Western societies. CSA experiences also differ, with substantially less penetrative and physical contact abuse in China. However, the psychological and behavioral profile of abused, young Chinese people, including the additional burden associated with contact abuse, is similar to that found in other cultures.     

Mental health indicators fifty years later: A population-based study of men with histories of child sexual abuse

Childhood sexual abuse (CSA) is a widely acknowledged trauma that affects a substantial number of boys/men and has the potential to undermine mental health across the lifespan. Despite the topic’s importance, few studies have examined the long-term effects of CSA on mental health in middle and late life for men. Most empirical studies on the effects of CSA have been conducted with women, non-probability samples, and samples of young or emerging adults with inadequate control variables. Based on complex trauma theory, the current study investigated: a) the effect of CSA on mental health outcomes (depressive symptoms, somatic symptom severity, hostility) in late life for men, and b) the moderating effects of childhood adversities and masculine norms in the relationship between CSA and the three mental health outcomes. Using a population-based sample from the 2004–2005 Wisconsin Longitudinal Study, multivariate analyses found that CSA was positively related to both depressive and somatic symptoms and increased the likelihood of hostility for men who reported a history of CSA. Both childhood adversities and masculine norms were positively related to the three outcomes for the entire sample. Among CSA survivors, childhood adversities exerted a moderating effect in terms of depressive symptoms. Mental health practitioners should include CSA and childhood adversities in assessment and treatment with men. To more fully understand the effects of CSA, future studies are needed that use longitudinal designs, compare male and female survivors, and examine protective mechanisms such as social support.     

The attitude towards nature,and incidence of sexual intimacy among students at a South African University

The authors, of the University of Stellenbosch, South Africa, surveyed 60 male university students of mean age 21.37 years and 79 female students of mean age 20.13 years with the goal of gaining insight into their sex behavior and their attitudes toward sexuality. The home language of 83% of the women and 85% of the men was Afrikaans, while the remaining subjects had English as a home language. One student was married, three were engaged to be married, and two lived together with a person of the opposite sex. 51 students were in steady relationships and 82 were single. 82% of the men and 90% of the women choose to have sex with someone of the same race. The study found a relatively low occurrence of sexual intercourse and promiscuity, and a very high percentage of subjects regarded themselves as heterosexual and as morally and religiously conservative. 97% of the men and 99% of the women regarded themselves as being heterosexual, and 3% of men and 1% of women regarded themselves as being bisexual. 6.6% of men and 1.34% of women, however, reported having had sexual contact with someone of the same sex. 37% of the men and 32% of the women reported having ever had sexual intercourse with a person of the opposite sex. These percentages are notably lower than those found by other investigators and the authors believe that a higher proportion of students at the university are actually sexually active than that suggested by this survey's findings. Among those sexually active, 17% of men and 18% of women were involved in sexual relationships with more than one partner. 68% of the sexually active men and women report using condoms often, 14% of men and 8% of women use contraceptives on an irregular basis, and 18% of men and 25% of women never use contraceptives. The birth control pill and condom were the most widely used methods. 85% of men and 86% of women felt that both partners should be responsible for taking precautions against unwanted pregnancy. These findings indicate that the overwhelming majority of subjects in this study are not at high risk for contracting AIDS.     

Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: Results from a nationally representative sample

Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.