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Psychological and behavioral moderators of the relationship between trauma severity and HIV transmission risk behavior among MSM with a history of childhood sexual abuse

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Abstract

Childhood sexual abuse (CSA) is associated with post-traumatic stress disorder (PTSD), which can be associated with condomless sex among men who have sex with men (MSM). However, the impact of moderating factors on the relationship between PTSD symptom severity and condomless sex is poorly understood. We examined whether PTSD symptom severity was associated with condomless sex among MSM with CSA histories, and whether substance dependence, self-esteem, and distress tolerance moderated that relationship (n = 288). Notably, no direct relationship between PTSD symptom severity and condomless sex was found. Adjusted models indicated that condomless sex was differentially impacted by PTSD symptom severity among those without substance dependence (ΔR2 = 0.03, p = 0.034) and, counterintuitively, those with high self-esteem (ΔR2 = 0.07, p = 0.005). PTSD symptom severity was associated with condomless sex across levels of distress tolerance. Findings indicate that substance use, self-esteem, and distress tolerance should be targeted in high-risk MSM with CSA even if they do not have PTSD.

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Acknowledgements

Funding was provided by National Institute of Mental Health (Grant No. R01MH095624).

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Abigail W. Batchelder & Conall O’Cleirigh

  2. Harvard Medical School, Boston, MA, USA

    Abigail W. Batchelder & Conall O’Cleirigh

  3. The Fenway Institute, Fenway Health, Boston, MA, USA

    Abigail W. Batchelder, Peter P. Ehlinger, Steven A. Safren & Conall O’Cleirigh

  4. University of Windsor, Windsor, ON, Canada

    Michael S. Boroughs

  5. School of Medicine, Boston University, Boston, MA, USA

    Jillian C. Shipherd

  6. Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA

    Jillian C. Shipherd

  7. Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Program, Veterans Health Adminstration, Washington, DC, USA

    Jillian C. Shipherd

  8. University of Miami, Coral Gables, FL, USA

    Steven A. Safren & Gail H. Ironson

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  1. Abigail W. Batchelder
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  2. Peter P. Ehlinger
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Correspondence to Abigail W. Batchelder.

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Abigail Batchelder, Peter P. Ehlinger, Michael S. Boroughs, Jillian C. Shipherd, Steven A. Safren, Gail H. Ironson, and Conall O’Cleirigh declares that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Batchelder, A.W., Ehlinger, P.P., Boroughs, M.S. et al. Psychological and behavioral moderators of the relationship between trauma severity and HIV transmission risk behavior among MSM with a history of childhood sexual abuse. J Behav Med 40, 794–802 (2017). https://doi.org/10.1007/s10865-017-9848-9

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