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AJPH First Look, published online ahead of print Apr 16, 2009
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AJPH.2008.138925v1
99/S2/S432    most recent
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October 2009, Vol 99, No. S2 | American Journal of Public Health S432-S438
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.138925

RESEARCH AND PRACTICE

Childhood Sexual Abuse and the Sociocultural Context of Sexual Risk Among Adult Latino Gay and Bisexual Men

Sonya Grant Arreola, PhD, MPH, Torsten B. Neilands, PhD and Rafael Díaz, PhD

Sonya Grant Arreola is with the HIV Research Section, Department of Public Health, San Francisco, CA. Torsten B. Neilands is with the Center for AIDS Prevention Studies, University of California, San Francisco. Rafael Díaz is with the Cesar Chavez Institute, California State University, San Francisco.

Correspondence: Requests for reprints should be sent to Sonya Grant Arreola, PhD, MPH, Scientific Director, Legacy Project, HIV Research Section, AIDS Office, San Francisco Department of Public Health, 25 Van Ness Ave, Suite 710, San Francisco, CA 94102 (e-mail: sonya.arreola{at}sfdph.org).

Objectives. We sought to examine the relationships among childhood sexual abuse, social discrimination, psychological distress, and HIV-risk among Latino gay and bisexual men in the United States.

Methods. Data were from a probability sample of 912 men from Miami, FL; Los Angeles, CA; and New York, NY. We used logistic regression and path analyses to examine direct and indirect effects of childhood sexual abuse on psychological distress and sexual risk behavior.

Results. We found a 15.8% (95% confidence interval = 12.3%, 19.2%) prevalence of childhood sexual abuse. Not having sex before age 16 years and having consensual sex before age 16 years did not differ from each other in predicting any of the outcomes of interest. Forced sex was associated with a significantly increased risk for all outcomes. A path analyses yielded direct effects of childhood sexual abuse and exposure to homophobia during childhood and during adulthood on psychological distress and indirect effects on risky sexual behavior.

Conclusions. HIV-risk patterns among Latino gay and bisexual men are related to childhood sexual abuse and a social context of discrimination, which combined lead to symptoms of psychological distress and participation in risky sexual situations that increase risky sexual behaviors associated with HIV acquisition.






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