Childhood sexual abuse and the sociocultural context of sexual risk among adult Latino gay and bisexual men

Abstract

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.

FIGURE 1

Standardized parameter estimates of direct and indirect effects of predictors of risky sexual behavior: Miami, FL; Los Angeles, CA; and New York, NY; October 1998–March 1999. Note. Results based on 880 respondents. Solid lines represent statistically significant direct effects of the regression of each mediator (i.e., psychological distress, risky sexual situations) on childhood sexual abuse, experiences of homophobia during childhood, and experiences of homophobia during adulthood. Dashed lines represent statistically significant indirect effects, which are the regressions of risky sexual behavior on childhood sexual abuse, experiences of homophobia during childhood, and experiences of homophobia during adulthood through (1) psychological distress, (2) risky sexual situations, or (3) psychological distress and risky sexual situations. Dashed lines that cross an intermediary variable (i.e., psychological distress, risky sexual situations) include that variable as a mediator. Results for control variables (i.e., nativity, age, and HIV serostatus) are included in the analysis but are not shown in the figure to preserve clarity. *P = .05; **P = .01; ***P = .001.