Journal of Family Violence

, Volume 21, Issue 4, pp 263–270 | Cite as

Childhood Sexual Abuse and HIV Risk Among Men Who Have Sex with Men: Initial Test of a Conceptual Model

  • Cheryl Gore-Felton
  • Seth C. KalichmanEmail author
  • Michael J. Brondino
  • Eric G. Benotsch
  • Marjorie Cage
  • Kari DiFonzo
Original Article


Childhood sexual abuse has been associated with HIV transmission risk behavior in men who have sex with men. This study examined an adapted model that was originally developed to explain the relationship between childhood sexual abuse and HIV risk behavior among women in a sample of men who have sex with men. Men attending a large gay pride event (n=647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse, symptoms of dissociation, trauma-related anxiety, borderline personality characteristics, hopelessness, substance use, and sexual risk behavior. A latent variable partial least squares analysis was conducted to test the interrelationships between childhood sexual abuse, exchanging sex for money or drugs, emotional disturbances, drug use, substance use in the context of sexual behavior, and sexual risk behavior. The model fit the data well and accounted for 10% of the total variance in sexual risk behavior. History of childhood sexual abuse predicted exchanging sex for money or drugs and this relationship was partly accounted for by active drug use. Substance use proximal to sexual behavior also emerged as a key factor in predicting sexual risk behavior. Findings from this study, therefore, indicate a direct association between history of child sexual abuse and high risk for HIV infection related to engaging in sex trade.


Childhood sexual abuse Risk behavior Trauma HIV 



The authors thank the AIDS Survival Project of Atlanta for their assistance with data collection. This research was supported by National Institute of Mental Health (NIMH) Grants R01-MH57624 and R01-MH63666.


  1. Acoca, L. (1998). Outside/inside: The violation of American girls at home, on the streets, and in the juvenile justice system. Crime and Delinquency, 44(4), 561–589.Google Scholar
  2. Beck, A. T., & Steer, R. A. (1988). Manual for the Beck Hopelessness Scale. San Antonio, TX: Psychological Corporation.Google Scholar
  3. Becker, E., Rankin, E., & Rickel, A. (1998). High-risk sexual behavior: Interventions with vulnerable populations. New York: Plenum.Google Scholar
  4. Bremner, J. D., Southwick, S. M., Johnson, D. R., Yehuda, R., & Charney, D. S. (1993). Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans. American Journal of Psychiatry, 150(2), 235–239.PubMedGoogle Scholar
  5. Briere, J., & Runtz, M. (1987). Post sexual abuse trauma. Journal of Interpersonal Violence, 2(4), 367–379.CrossRefGoogle Scholar
  6. Carballo-Diéguez, A., & Dolezal, C. (1995). Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. Child Abuse and Neglect, 19(5), 595–605.PubMedCrossRefGoogle Scholar
  7. Clark, L. A. (1993). Schedule for nonadaptive and adaptive personality manual for administration, scoring, and interpretation. Minneapolis, MN: University of Minnesota Press.Google Scholar
  8. Dembo, R., Dertke, M., Borders, S., Washburn, M., & Schmeidler, J. (1988). The relationship between physical and sexual abuse and tobacco, alcohol, and illicit drug use among youths in a juvenile detention center. The International Journal of the Addictions, 23(4), 351–378.PubMedGoogle Scholar
  9. Doll, L., Joy, D., Bartholow, B., Harrison, J., Bolan, G., Douglas, J., et al. (1992). Self-reported childhood and adolescent sexual abuse among adult homosexual and bisexual men. Child Abuse and Neglect, 16(6), 855–864.PubMedCrossRefGoogle Scholar
  10. Falk, R. F., & Miller, N. B. (1992). A primer for soft modeling. Akron, OH: University of Akron Press.Google Scholar
  11. Finkelhor, D., Hotaling, G., Lewis, I. A., & Smith, C. (1990). Sexual abuse in a national survey of adult men and women: Prevalence, characteristics, and risk factors. Child Abuse and Neglect, 14(1), 19–28.PubMedCrossRefGoogle Scholar
  12. Georgia Division of Public Health (2001). HIV/AIDS surveillance report. Available from the Author.Google Scholar
  13. Harrison, J. A., & Watson, D. (1996). Dissociative processes in normal-range functioning. Unpublished manuscript, The University of Iowa.Google Scholar
  14. Hickson, F., Reid, D., Davies, P., Weatherburn, P., Beardsell, S., & Keogh, P. (1996). No aggregate change in homosexual HIV risk behaviour among gay men attending the Gay Pride Festivals, United Kingdom, 1993–1995. AIDS, 10, 771–774.PubMedGoogle Scholar
  15. Jinich, S., Paul, J. P., Stall, R., Acree, M., Kegeles, S., Hoff, C. et al. (1998). Childhood sexual abuse and HIV risk-taking behavior among gay and bisexual men. AIDS and Behavior, 2(1), 41–51.CrossRefGoogle Scholar
  16. Kalichman, S. C. (1998). Preventing AIDS: A sourcebook for behavioral interventions. Hillsdale, NJ: LEA.Google Scholar
  17. Kalichman, S. C., & Rompa, D. (1995). Sexually coerced and noncoerced gay and bisexual men: Factors relevant to risk for Human Immunodeficiency Virus (HIV) infection. Journal of Sex Research, 32(1), 45–50.CrossRefGoogle Scholar
  18. Koss, M. P., & Gidycz, C. A. (1985). Sexual experiences survey: Reliability and validity. Journal of Consulting and Clinical Psychology, 53, 422–423.PubMedCrossRefGoogle Scholar
  19. Lodico, M., & DiClemente, R. (1994). The association between childhood sexual abuse and HIV related risk behaviors. Clinical Pediatrics, 33, 498–502.PubMedGoogle Scholar
  20. McCauley, J., Kern, D. E., Kolodner, K., Dill, L., & Schroeder, A. F. (1997). Clinical characteristics of women with a history of childhood abuse: Unhealed wounds. JAMA, 277(17), 1362–1368.Google Scholar
  21. Miller, M. (1999). A model to explain the relationship between sexual abuse and HIV risk among women. AIDS Care, 11(1), 3–20.PubMedCrossRefGoogle Scholar
  22. Pedhazur, E. J. (1982). Multiple regression in behavioral research. New York: Holt, Rinehart, and Winston.Google Scholar
  23. Polusny, M. A., & Follette, V. M. (1995). Long term correlates of child sexual abuse: Theory and review of the empirical literature. Applied and Preventive Psychology, 4, 143–166.CrossRefGoogle Scholar
  24. Pribor, E. F., & Dinwiddie, S. H. (1992). Psychiatric correlates of incest in childhood. American Journal of Psychiatry, 149(1), 52–56.PubMedGoogle Scholar
  25. Shroder, K., Carey, M., & Vanable, P. (2003). Methodological challenges in research on sexual risk behaviors: II Accuracy of self-reports. Annals of Behavioral Medicine, 26, 104–123.CrossRefGoogle Scholar
  26. Stall, R., & Purcell, D. (2000). Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS and Behavior, 4, 181–192.CrossRefGoogle Scholar
  27. Wilsnack, S. C., Vogeltanz, N. D., Klassen, A. D., & Harris, T. R. (1997). Childhood sexual abuse and women’s substance abuse: National survey findings. Journal of Studies on Alcohol, 58(3), 264–271.PubMedGoogle Scholar
  28. Yung, Y. F., & Bentler, P. M. (1994). Bootstrap- corrected ADF test statistics in covariance structure analysis. British Journal of Mathematical and Statistical Psychology, 47, 63–84.PubMedGoogle Scholar
  29. Zierler, S., Feingold, L., Laufer, D., Velentgas, P., Kantrowitz-Gordon, I., & Mayer, K. (1991). Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. American Journal of Public Health, 81, 572–575.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Cheryl Gore-Felton
    • 1
  • Seth C. Kalichman
    • 2
    Email author
  • Michael J. Brondino
    • 1
  • Eric G. Benotsch
    • 1
  • Marjorie Cage
    • 1
  • Kari DiFonzo
    • 1
  1. 1.Medical College of WisconsinMilwaukeeUSA
  2. 2.Department of PsychologyUniversity of ConnecticutStorrsUSA

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