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AJPH First Look, published online ahead of print Apr 16, 2009
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AJPH.2007.133280v1
99/6/1079    most recent
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June 2009, Vol 99, No. 6 | American Journal of Public Health 1079-1086
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.133280

RESEARCH AND PRACTICE

History of Childhood Sexual Abuse and Unsafe Anal Intercourse in a 6-City Study of HIV-Positive Men Who Have Sex With Men

Seth L. Welles, ScD, PhD, A. Cornelius Baker, BA, Michael H. Miner, PhD, David J. Brennan, PhD, Scott Jacoby, MA and B. R. Simon Rosser, PhD, MPH

At the time of the study, Seth L. Welles was with the School of Public Health, Boston University, Boston, MA. A. Cornelius Baker was with the Academy for Educational Development Center on AIDS and Community Health, Washington, DC. Michael H. Miner, Scott Jacoby, and B. R. Simon Rosser were with the Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis. David Brennan was with the School of Social Work, Boston College, Boston.

Correspondence: Requests for reprints should be sent to Seth L. Welles, Department of Epidemiology and Biostatistics, Drexel University School of Public Health, 1505 Race St, Philadelphia, PA 19102 (e-mail: slw58{at}drexel.edu).

Objectives. We assessed rates of childhood sexual abuse and its demographic and mental health correlates among HIV-positive men who reported unsafe anal intercourse with other men in the past year.

Methods. We conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men enrolled in the Positive Connections intervention.

Results. Childhood sexual abuse was reported by 47% of participants; 32% reported frequency as often or sometimes. Men reporting abuse were more likely to be Latino (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.6, 4.2; P < .001) or African American (OR = 1.8; 95% CI = 1.2, 2.7; P = .005) than White. Among those who were abused, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR] = 1.3; P < .001) and unsafe anal intercourse (often, RR = 1.5; sometimes, RR = 2.0; P < .001) compared with men who were not abused.

Conclusions. History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color. Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections.






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