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

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. (Am J Public Health. 2009;99:1079-1086. doi:10.2105/AJPH.2007.133280)