Archives of Sexual Behavior

, Volume 42, Issue 2, pp 257–265 | Cite as

Sexual Risk Behaviors by Relationship Type and Trauma History Among HIV-Positive Men Who Have Sex with Men

  • Charles Kamen
  • Darryl Etter
  • Sergio Flores
  • Susan Sharp
  • Susanne Lee
  • Cheryl Gore-Felton
Original Paper

Abstract

The association of trauma exposure and coping style to sexual risk behavior has yet to be fully examined in the context of primary and casual sexual partnerships. The current study assessed a high risk sexual behavior—unprotected anal intercourse (UAI)—in a high risk population of HIV-positive men who have sex with men (MSM) with a history of trauma. Using audio computer-assisted self-interview technology, 132 HIV-positive MSM completed measures of trauma exposure, trauma symptoms, coping strategies, and sexual risk behavior. Hierarchical logistic regression analyses indicated that completing more years of education and having experienced sexual abuse were positively associated with UAI with casual partners. Additionally, use of active coping was negatively associated with UAI with casual partners and the final model significantly predicted variance in UAI with casual partners. However, no variables were significantly associated with UAI with primary partners, suggesting that sexual risk behavior with primary partners may be associated with factors not commonly assessed in risk prediction or prevention research. We discuss the results in the context of developing new or modifying existing interventions to address rates of sexual risk in the relationships of HIV-positive MSM.

Keywords

HIV Sexual risk taking Trauma Coping Sexual partners Men who have sex with men 

References

  1. Arreola, S. G., Neilands, T. B., & Dítaz, R. (2009). Childhood sexual abuse and the sociocultural context of sexual risk among adult Latino gay and bisexual men. American Journal of Public Health, 99(S2), S432–S438.PubMedCrossRefGoogle Scholar
  2. Ben-Zur, H., & Zeidner, M. (2009). Threat to life and risk-taking behaviors: A review of empirical findings and explanatory models. Personality and Social Psychology Review, 13, 109–128.PubMedCrossRefGoogle Scholar
  3. Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92.PubMedCrossRefGoogle Scholar
  4. Catania, J. A., Paul, J., Osmond, D., Folkman, S., Pollack, L., Canchola, J., … Neilands, T. (2008). Mediators of childhood sexual abuse and high-risk sex among men-who-have-sex-with-men. Child Abuse and Neglect, 32, 925–940.PubMedCrossRefGoogle Scholar
  5. Centers for Disease Control and Prevention. (2010). HIV among gay, bisexual and other men who have sex with men (MSM). Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  6. Coates, T. J., Richter, L., & Caceres, C. (2008). Behavioural strategies to reduce HIV transmission: How to make them work better. Lancet, 372, 669–684.PubMedCrossRefGoogle Scholar
  7. Crawford, J. M., Kippax, S. C., Mao, L., Van de Ven, P. G., Prestage, G. P., Grulich, A. E., et al. (2006). Number of risk acts by relationship status and partner serostatus: Findings from the HIV cohort of homosexually active men in Sydney, Australia. AIDS and Behavior, 10, 325–331.PubMedCrossRefGoogle Scholar
  8. Creamer, M., Bell, R., & Failla, S. (2003). Psychometric properties of the Impact of Event Scale—Revised. Behaviour Research and Therapy, 41, 1489–1496.PubMedCrossRefGoogle Scholar
  9. Dilley, J. W., Woods, W. J., & McFarland, W. (1997). Are advances in treatment changing views about high-risk sex? New England Journal of Medicine, 337, 501–502.PubMedCrossRefGoogle Scholar
  10. Dude, A., Oruganti, G., Kumar, V., Mayer, K. H., Yeldandi, V., & Schneider, J. A. (2009). HIV infection, genital symptoms and sexual risk behavior among Indian truck drivers from a large transportation company in South India. Journal of Global Infectious Disease, 1, 21–28.CrossRefGoogle Scholar
  11. Gore-Felton, C., Butler, L. D., & Koopman, C. (2001). HIV disease, violence, and post- traumatic stress. Focus: A Guide to AIDS Research and Counseling, 16(6), 5–6.Google Scholar
  12. Gore-Felton, C., & Koopman, C. (2002). Traumatic experiences: Harbinger of risk behavior among HIV-positive adults. Journal of Trauma & Dissociation, 3, 121–135.CrossRefGoogle Scholar
  13. Green, B. L. (1996). Psychometric review of Trauma History Questionnaire (Self-report). In B. H. Stamm & E. M. Varra (Eds.), Measurement of stress, trauma and adaptation (pp. 366–369). Lutherville, MD: Sidran.Google Scholar
  14. Hall, H. I., Song, R., Rhodes, P., Prejean, J., An, Q., Lee, L. M., et al. (2008). Estimation of HIV incidence in the United States. Journal of the American Medical Association, 300, 520–529.PubMedCrossRefGoogle Scholar
  15. Kalichman, S. C., Sikkema, K. J., DiFonzo, K., Luke, W., & Austin, J. (2002). Emotional adjustment in survivors of sexual assault living with HIV-AIDS. Journal of Traumatic Stress, 15, 289–296.PubMedCrossRefGoogle Scholar
  16. Kelly, B. C., Bimbi, D. S., Izienicki, H., & Parsons, J. T. (2009). Stress and coping among HIV-positive barebackers. AIDS and Behavior, 13, 792–797.PubMedCrossRefGoogle Scholar
  17. Kiecolt-Glaser, J. K., & Newton, T. I. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472–503.PubMedCrossRefGoogle Scholar
  18. Kippax, S., Noble, J., Prestage, G., Crawford, J. M., & Campbell, D. (1997). Sexual negotiation in the AIDS era: Negotiated safety revisited. AIDS, 11, 191–197.PubMedCrossRefGoogle Scholar
  19. Leserman, J., Whetten, K., Lowe, K., Stangl, D., Swartz, M. S., & Thielman, N. M. (2005). How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the South. Psychosomatic Medicine, 67, 500–507.PubMedCrossRefGoogle Scholar
  20. Liebschutz, J. M., Geier, J. L., Horton, N. J., Chuang, C. H., & Samet, J. H. (2005). Physical and sexual violence and health care utilization in HIV-infected persons with alcohol problems. AIDS Care, 17, 566–578.PubMedCrossRefGoogle Scholar
  21. Macaluso, M., Demand, M. D., Artz, L. M., & Hook, E. M. (2000). Partner type and condom use. AIDS, 14, 537–546.PubMedCrossRefGoogle Scholar
  22. Martin, J. I., Pryce, J. G., & Leeper, J. D. (2005). Avoidance coping and HIV risk behavior among gay men. Health and Social Work, 30, 193–201.PubMedCrossRefGoogle Scholar
  23. Metro Public Health Department. (2001). Community Health Behavior Survey. Nashville, TN: Author. Retrieved from http://health.nashville.gov/PDFs/HealthData/ExecutiveSummarythruListsTables.pdf
  24. Osmond, D. H., Pollack, L. M., Paul, J. P., & Catania, J. A. (2007). Changes in prevalence of HIV infection and sexual risk behavior in men who have sex with men in San Francisco: 1997–2002. American Journal of Public Health, 97, 1677–1683.PubMedCrossRefGoogle Scholar
  25. Parsons, J. T., Schrimshaw, E. W., Wolitski, R. J., Halkitis, P. N., Purcell, D. W., Hoff, C. C., et al. (2005). Sexual harm reduction practices of HIV-seropositive gay and bisexual men: Serosorting, strategic positioning, and withdrawal before ejaculation. AIDS, 19(Suppl. 1), S13–S25.PubMedCrossRefGoogle Scholar
  26. Paul, J. P., Catania, J., Pollack, L., & Stall, R. (2001). Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: The Urban Men’s Health Study. Child Abuse and Neglect, 25, 557–584.PubMedCrossRefGoogle Scholar
  27. Poppen, P. J., Reisen, C. A., Zea, M. C., Bianchi, F. T., & Echeverry, J. J. (2005). Serostatus disclosure, seroconcordance, partner relationship, and unprotected anal intercourse among HIV-positive Latino men who have sex with men. AIDS Education and Prevention, 17, 227–237.PubMedCrossRefGoogle Scholar
  28. Remien, R. H., Wagner, G., Dolezal, C., & Carballo-Diéguez, A. (2001). Factor associated with HIV sexual risk behavior in male couples of mixed HIV status. Journal of Psychology & Human Sexuality, 13(2), 31–48.CrossRefGoogle Scholar
  29. Robins, A. G., Dew, M. A., Kingsley, L. A., & Becker, J. T. (1997). Do homosexual and bisexual men who place others at potential risk for HIV have unique psychological profiles? AIDS Education and Prevention, 9, 239–251.PubMedGoogle Scholar
  30. Schraufnagel, T. J., Davis, K. C., George, W. H., & Norris, J. (2010). Childhood sexual abuse in males and subsequent risky sexual behavior: A potential alcohol-use pathway. Child Abuse and Neglect, 34, 369–378.PubMedCrossRefGoogle Scholar
  31. Semple, S. J., Patterson, T. L., & Grant, I. (2003). HIV-positive gay and bisexual men: Predictors of unsafe sex. AIDS Care, 15, 3–15.PubMedCrossRefGoogle Scholar
  32. Sikkema, K. J., Hansen, N. B., Meade, C. S., Kochman, A., & Fox, A. M. (2009). Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood. Archives of Sexual Behavior, 38, 121–134.PubMedCrossRefGoogle Scholar
  33. Sikkema, K. J., Wilson, P. A., Hansen, N. B., Kochman, A., Neufeld, S., Ghebremichael, M. S., et al. (2008). Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse. Journal of Acquired Immune Deficiency Syndromes, 47, 506–513.PubMedCrossRefGoogle Scholar
  34. Smith, J., Nalagoda, F., Wawer, M. J., Serwadda, D., Sewankambo, N., Konde-Lule, J., … Gray, R. H. (1999). Educational attainment as a predictor of HIV risk in rural Uganda: Results from a population-based study. International Journal of STD and AIDS, 10, 452–459.PubMedCrossRefGoogle Scholar
  35. Strathdee, S., Hogg, R., Martindale, S., Cornelisse, P., Craib, K., Montaner, J., … Schechter, M. (1998). Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 19, 61–66.PubMedCrossRefGoogle Scholar
  36. Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23, 1153–1162.PubMedCrossRefGoogle Scholar
  37. Valdiserri, R. O. (2004). Mapping the roots of HIV/AIDS complacency: Implications for program and policy development. AIDS Education and Prevention, 16, 426–439.PubMedCrossRefGoogle Scholar
  38. Vanable, P. A., McKirnan, D. J., Buchbinder, S. P., Bartholow, B. N., Douglas, J. M., Judson, F. N., et al. (2004). Alcohol use and high-risk sexual behavior among men who have sex with men: The effects of consumption level and partner type. Health Psychology, 23, 525–532.PubMedCrossRefGoogle Scholar
  39. Weinhardt, L. S., Kelly, J. A., Brondino, M. J., Rotheram-Borus, M. J., Kirshenbaum, S. B., & Chesney, Gore.-Felton. C. (2004). HIV transmission risk behavior among men and women living with HIV in 4 cities in the United States. Journal of Acquired Immune Deficiency Syndromes, 36, 1057–1066.PubMedCrossRefGoogle Scholar
  40. Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event Scale—Revised. In J. Wilson, T. Keane, J. Wilson, & T. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399–411). New York: Guilford Press.Google Scholar
  41. Yi, H., Sandfort, T. G., & Shidlo, A. (2010). Effects of disengagement coping with HIV risk on unprotected sex among HIV-negative gay men in New York City. Health Psychology, 29, 205–214.PubMedCrossRefGoogle Scholar
  42. Zierler, S., Cunningham, W. E., Andersen, R., Shapiro, M. F., Nakazono, T., Morton, S., … Bozzette, S. A. (2000). Violence victimization after HIV infection in a U.S. probability sample of adult patients in primary care. American Journal of Public Health, 90, 208–215.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Charles Kamen
    • 1
  • Darryl Etter
    • 2
  • Sergio Flores
    • 2
  • Susan Sharp
    • 2
  • Susanne Lee
    • 1
  • Cheryl Gore-Felton
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordUSA
  2. 2.Pacific Graduate School of Psychology/Stanford ConsortiumPalo AltoUSA

Personalised recommendations