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Mediating factors in the relationship between childhood sexual abuse and HIV Sexual risk behaviour among men who have sex with men

Previous studies have indicated an association between childhood sexual abuse (CSA) and an increased risk of engaging in unsafe behaviours during adulthood, including risky sexual practices. This study examined the relationship between CSA and adult HIV sexual risk behaviour among a sample of South African men who have sex with men (MSM). Potential pathological long-term mental health outcomes of CSA, including dissociation, sex-related substance abuse, depression, sexual compulsivity, impaired interpersonal communication, and over-reliance on submissive sexual scripts, were treated as variables mediating the relationship between CSA and sexual risk behaviour. Men frequenting a gay internet dating site were randomly selected to complete an electronic version of the anonymous survey. Results indicate that one-fourth of participants reported a history of CSA. Men with a history of unwanted sexual activity during childhood were more likely to report recreational substance abuse, sex-related substance abuse, sexual compulsivity, and adult revictimisation experiences. Men who were abused were also more likely to engage in unprotected anal intercourse compared to those who were not abused. Mediation analyses revealed that MSM who are survivors of CSA are particularly susceptible to drug abuse, sex-related drug abuse, and sexual compulsivity, and these sequelae in turn predict higher reported numbers of male sexual partners. The current data suggest that CSA is widespread among men at high risk for HIV infection, and that it may have a devastating influence on the quality of life and health risk behaviour of these men. These results also highlight the importance of mental health services and new approaches in HIV prevention for MSM who have been sexually abused as children. Further research is needed into the contextual factors of the childhood abuse experience which account for the variability in longterm negative mental health outcomes of CSA survivors.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nmmu/vital:9873
Date January 2010
CreatorsHeusser, Shelly Lucien
PublisherNelson Mandela Metropolitan University, Faculty of Health Sciences
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis, Masters, MA
Formatxii, 143 p, pdf
RightsNelson Mandela Metropolitan University

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