Decreasing HIV in MSM – Legalizing Sodomy or Stopping Childhood Sexual Abuse ?

Childhood  Sexual  Abuse  (CSA)  is  a  known  marker  for  risky  sexual  behaviour  as  research  below  shows.

Legalizing  sodomy  has not  been  shown to  lead  to  sustained  decrease  in  HIV/AIDS  among  MSM  so  why  are  the  eminent  persons  group  of  the  Commonwealth  and  UNAIDS  ignoring  the  plight  of  our  children  to  advance  the   failed  policy   of  legalization  of  sodomy ?

 A)

J Gen Intern Med. 1997 Apr;12(4):250-3.

Childhood sexual abuse among homosexual men. Prevalence and association with unsafe sex.

Lenderking WR, Wold C, Mayer KH, Goldstein R, Losina E, Seage GR 3rd.

Source

Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA.

Abstract

Of 327 homosexual and bisexual men participating in an ongoing cohort study pertaining to risk factors for HIV infection who completed a survey regarding history of sexual abuse, 116 (35.5%) reported being sexually abused as children. Those abused were more likely to have more lifetime male partners, to report more childhood stress, to have lied in the past in order to have sex, and to have had unprotected receptive anal intercourse in the past 6 months (odds ratio 2.13; 95% confidence interval 1.15-3.95). Sexual abuse remained a significant predictor of unprotected receptive anal intercourse in a logistic model adjusting for potential confounding variables.

B)

Am J Public Health. 2009 Jun;99(6):1079-86. Epub 2009 Apr 16.

History of childhood sexual abuse and unsafe anal intercourse in a 6-city study of HIV-positive men who have sex with men.

Welles SL, Baker AC, Miner MH, Brennan DJ, Jacoby S, Rosser BR.

Source

Boston University, MA, USA. slw58@drexel.edu

Abstract

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.

C)

J Acquir Immune Defic Syndr. 2011 Nov 11. [Epub ahead of print]

ASSOCIATIONS OF SEXUAL IDENTITY OR SAME-SEX BEHAVIORS WITH HISTORY OF CHILDHOOD SEXUAL ABUSEAND HIV/STI RISK IN THE UNITED STATES.

Sweet T, Welles S.

Source

Drexel University School of Public Health, Department of Epidemiology and Biostatistics.

Abstract

OBJECTIVE:

To measure associations of childhood sexual abuse (CSA) with sexual orientation, behaviors, and attractions and HIV/STI incidence in a nationally representative sample of men and women.

METHODS:

Data from the 2004-2005 Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed, including frequencies of CSA and HIV/STI incidence for five subgroups defined by sexual orientation based on identity, and behaviors and attraction to the same-or opposite-sex.

RESULTS:

Overall, 14.9% of women and 5.2% of men reported CSA. Among women, bisexuals, lesbians and heterosexuals with same-sex partners had 5.3-times, 3.4-times, and 2.9-times the odds, respectively, for CSA occurring sometimes/more frequently (vs. never) compared with heterosexuals not having same-sex partners or attractions.Among men, bisexuals, gay men, and heterosexuals with same-sex partners had 12.8-times, 9.5-times, and 7.9-times the odds, respectively, for CSA. Men and women sometimes or frequently abused had significant increases in odds for HIV/STI incidence compared to those not abused.Among women, sexual minorities had 3.8-times the odds and heterosexuals had 2.8-times the odds, while among men, sexual minorities had 4.2-times odds and heterosexuals had 1.5-times odds.

CONCLUSIONS:

Extraordinarily high rates of CSA were observed for sexual minorities and sexual minorities were more likely to have incident HIV or STIs, in this U.S. population survey.Identifying the impact of CSA among heterosexuals and sexual minorities in the US is a crucial first step in examining the sequelae of childhood sexual abuse, including the potential mediators of mental health and substance abuse disorders in the relationship between CSA and sexual risk taking.

D)

Am J Prev Med. 2000 Feb;18(2):151-8.

Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking.

Bensley LS, Van Eenwyk J, Simmons KW.

Source

Washington State Department of Health, Olympia 98504-7812, USA. lsb0303@doh.wa.gov

Abstract

CONTEXT:

Although studies of clinical samples have identified links between childhood abuse, especially sexual abuse, and adult health-risk behaviors, the generalizability of these findings to the population and the relative importance of different types of abuse in men and women are not known.

OBJECTIVE:

To estimate the risk of self-reported adult HIV-risk behaviors and heavy drinking that is associated with self-reported childhood histories of physical and/or sexual abuse for men and women in a general-population sample, after controlling for age and education. A second objective is to determine whether, among women, early and chronic sexual abuse is associated with heightened risk compared to later or less extensive abuse.

DESIGN:

A population-based telephone survey, the 1997 Washington State Behavioral Risk Factor Surveillance System (BRFSS), asked a representative sample of adults whether they had ever been physically or sexually abused in childhood, and if so, the age at first occurrence and number of occurrences. The survey also asked about levels of alcohol use and, for those under 50 years, about HIV-risk behaviors.

PARTICIPANTS:

Three thousand four hundred seventy-three English-speaking non-institutionalized civilian adults in Washington State.

MAIN OUTCOME MEASURES:

Self-reported HIV-risk behaviors in the past year and heavy drinking in the past month.

RESULTS:

We identified associations between reported abuse history and each health-risk behavior that we examined. For women, early and chronic sexual abuse (occurring without nonsexual physical abuse) was associated with more than a 7-fold increase in HIV-risk behaviors (odds ratio [OR], 7.4; 95% confidence intervals [CI] 2.4 to 23.5); and any sexual abuse, combined with physical abuse, was associated with a 5-fold increase in these risk behaviors (OR, 5.0; 95% CI, 2.2 to 11.5). For women, only combined sexual and physical abuse was associated with heavy drinking (OR, 6.2; 95% CI, 2.2 to 16.9). Physical abuse alone was not associated with either health-risk behavior for women. For men, any sexual abuse was associated with an 8-fold increase in HIV-risk behaviors (OR, 7.9; 95% CI, 1.8 to 35.1). Physical abuse alone was associated with a 3-fold increase in risk of HIV-risk behaviors (OR, 3.2; 95% CI, 1.3 to 7.9) and a similar increase in risk of heavy drinking (OR, 3.2; 95% CI, 1.8 to 5.5). Although only 29% of the women and 19% of the men who were asked about HIV-risk behaviors reported any history of childhood abuse, these accounted for 51% and 50% of those reporting HIV-risk behaviors, respectively. For heavy drinking the corresponding figures were 25% of the women and 23% of the men reporting any abuse, who accounted for 45% and 33% of those reporting heavy drinking, respectively.

CONCLUSIONS:

Efforts to prevent or remediate adult health-risk behaviors should consider the possibility of a history of childhood abuse, as one third to one half of those reporting HIV-risk behaviors or heavy drinking in a general-population survey also reported childhood abuse.

 E)

J Acquir Immune Defic Syndr. 2009 Jul 1;51(3):340-8.

Childhood sexual abuse is highly associated with HIV risk-taking behavior and infection among MSM in the EXPLORE Study.

Mimiaga MJ, Noonan E, Donnell D, Safren SA, Koenen KC, Gortmaker S, O’Cleirigh C, Chesney MA, Coates TJ, Koblin BA, Mayer KH.

Source

Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. mmimiaga@fenwayhealth.org

Abstract

BACKGROUND:

Previous studies have found high rates of childhood sexual abuse (CSA) among US men who have sex with men (MSM). CSA history has been associated with a variety of negative effects later in life including behaviors that place MSM at greater risk for HIV acquisition and transmission. The present analysis is the first to examine the longitudinal association between CSA and HIV infection, unprotected anal sex, and serodiscordant unprotected anal sex, as well as mediators of these relationships among a large sample of HIV-uninfected MSM.

METHODS:

The EXPLORE Study was a behavioral intervention trial conducted in 6 US cities over 48 months with HIV infection as the primary efficacy outcome. Behavioral assessments were done every 6 months via confidential computerized assessments. Longitudinal regression models were constructed, adjusting for randomization arm, geographical location of study site, age at enrollment, education, and race/ethnicity.

RESULTS:

Of the 4295 participants enrolled, 39.7% had a history of CSA. Participants with a history of CSA [adjusted hazards ratio = 1.30, 95% confidence interval (CI): 1.02 to 1.69] were at increased risk for HIV infection over study follow-up. A significant association was seen between history of CSA and unprotected anal sex (adjusted odds ratio = 1.24, 95% CI: 1.12 to 1.36) and serodiscordant unprotected anal sex (adjusted odds ratio = 1.30, 95% CI: 1.18 to 1.43). Among participants reporting CSA, the EXPLORE intervention had no effect in reducing HIV infection rates. Participants reporting CSA were significantly more likely to have symptoms of depression and use nonprescription drugs.

CONCLUSIONS:

A predictive relationship between a history of CSA and subsequent HIV infection was observed among this large sample of HIV-uninfected MSM. Findings indicate that HIV-uninfected MSM with CSA histories are at greater risk for HIV infection, report higher rates of HIV sexual risk behavior, and may derive less benefit from prevention programs. Future HIV prevention interventions should address the specific mental health concerns of MSM with a history of CSA.

F)

Child Abuse Negl. 2001 Apr;25(4):557-84.

Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men’s Health Study.

Paul JP, Catania J, Pollack L, Stall R.

Source

University of California, San Francisco, Center for AIDS Prevention Studies, 94105, USA.

Abstract

OBJECTIVE:

The prevalence and characteristics of childhood sexual abuse (CSA) among men who have sex with men (MSM), and links with sexual risk are explored. A model linking CSA and sexual risk among MSM is proposed.

METHOD:

A telephone probability sample of urban MSM (n = 2881) was recruited and interviewed between November 1996 and February 1998. The interview covered numerous health issues, including history of sexual victimization.

RESULTS:

One-fifth reported CSA, primarily by non-family perpetrators. Initial CSA experiences are characterized by high levels of force (43% involved physical force/weapons), and penetrative sex (78%; 46% reported attempted or actual anal intercourse). Such men are more likely than nevercoerced men to engage in high risk sex (unprotected anal intercourse with a non-primary partner or with a serodiscordant male). In multivariate analyses, the effect of childhood sexual coercion on sexual risk is mediated by substance use, patterns of sexual contacts, and partner violence, but not by adult sexual revictimization or by depression.

CONCLUSIONS:

Findings are interpreted within the context of social learning theory and prior research on sexual risk-taking. The high risk for CSA among MSM, which can predispose such men to patterns of HIV sexual risk, warrants new approaches in HIV prevention.

 G)

Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Jan;30(1):14-7.

[The impact of childhood sexual abuse on the development of AIDS related high risk behaviors and psychological appearances among men who have sex with men].

[Article in Chinese]

Yu ZZ, Zhang BC, Li XF, Wang N, Shi TX, Chu QS.

Source

Department of Dermatology, the Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China.

Abstract

OBJECTIVE:

To study the AIDS related high risk behaviors and psychological appearances among men who have sex with men (MSM) who ever experienced childhood sexual abuse (CSA).

METHODS:

Target sampling for a cross-sectional study was developed and valid anonymous questionnaires were adopted to compare the differences of high risk behaviors related to AIDS and psychological appearances between those with or without CSA experiences among 2147 MSM from nine cities.

RESULTS:

Compared to corresponding ones without CSA experience, CSA group had a significant larger numbers in the following events: total sexual partners, anal sex episodes with same sex, female sexual partners and anal sex in the previous six months, with the figures of median as 20.0, 10.0, 3.0, 3.0 respectively. In the previous year, 30.8% of them had ever participated in ‘group sex’, 19.2% ever exchanged money for sex, 36.7% bled while having sexual intercourse, 37.3% had sex with male partners away from his own region. All the above said figures were higher than non-CSA group, with significant differences. It also appeared that CSA experience had an impact on significant lower rate of condom use (67.3%) in the last anal sex. Those with CSA experience had more psychological problems which appeared as: 75.6% considered they would suffer from serious discrimination if their sexual orientation ever disclosed, 34.7% had a strong intention of suicide and 24.3% ever having had suicidal attempts. The differences of the two groups showed statistical significance.

CONCLUSION:

CSA experience not only increased the number of AIDS related high risk behaviors in adulthood, but also had negative impact on their psychological appearances. It is of urgent need to carry out psychological intervention approaches to target on MSM with CSA experiences while childhood sexual education and rights assurance towards juvenile population should also not be neglected.

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