AIDS and Behavior

, Volume 23, Issue 9, pp 2421–2431 | Cite as

Cognitive Behavioral Therapy for Trauma and Self-Care (CBT-TSC) in Men Who have Sex with Men with a History of Childhood Sexual Abuse: A Randomized Controlled Trial

  • Conall O’CleirighEmail author
  • Steven A. Safren
  • S. Wade Taylor
  • Brett M. Goshe
  • C. Andres Bedoya
  • Samantha M. Marquez
  • Michael S. Boroughs
  • Jillian C. Shipherd
Original Paper


To address childhood sexual abuse (CSA) related distress and HIV risk in men who have sex with men (MSM) using cognitive-behavioral therapy for trauma and self-care (CBT-TSC), which is a novel intervention integrating HIV risk reduction with modified cognitive and behavioral therapy strategies for post-traumatic stress. We compared CBT-TSC to HIV voluntary counseling and testing (VCT)-only in an initial 2-arm RCT in 43 HIV-negative MSM at with a history of CSA and HIV risk. Serodiscordant condomless anal/vaginal sex (CAS; CAS with HIV-postive or HIV unknown status partners) and posttraumatic stress disorder (PTSD) symptoms (Davidson Trauma Scale: total score and avoidance, intrusions, hyperarousal subscales) were outcomes immediately post-treatment, and at 6- and 9-month follow-up. At post-treatment, CBT-TSC had decreased odds (approximately 60%) of any CAS and greater reductions in CAS compared to VCT-only. Additionally, the CBT-TSC condition experienced greater reductions in total PTSD and avoidance symptoms. At the follow-up visits, CBT-TSC condition had significant reductions in the odds of any CAS and reductions in CAS. However, for PTSD symptoms, only the avoidance subscale remained significantly different compared to VCT-only. CBT-TSC is a potentially efficacious approach to address HIV risk in MSM with a CSA history, with replication and extension in a larger trial needed. This proof-of-concept trial is the first to integrate the treatment of a commonly occurring mental-health syndemic problem in MSM with a health psychology approach to self-care in MSM.

Trial Registration NCT01266122


Trauma HIV Men who have sex with men Childhood sexual abuse 



Funding from this project was from Grant R34MH081760 awarded to Conall O’Cleirigh. Dr. Safren was also supported by Grant 9K24DA040489.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Conall O’Cleirigh
    • 1
    • 2
    • 3
    Email author
  • Steven A. Safren
    • 3
    • 4
  • S. Wade Taylor
    • 3
    • 9
  • Brett M. Goshe
    • 1
    • 2
  • C. Andres Bedoya
    • 1
    • 2
  • Samantha M. Marquez
    • 1
    • 3
  • Michael S. Boroughs
    • 10
  • Jillian C. Shipherd
    • 5
    • 6
    • 7
    • 8
  1. 1.Department of PsychiatryMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.The Fenway Institute of Fenway HealthBostonUSA
  4. 4.Department of PsychologyUniversity of MiamiCoral GablesUSA
  5. 5.VA Boston Healthcare SystemBostonUSA
  6. 6.Women’s Health Sciences DivisionNational Center for PTSDBostonUSA
  7. 7.Department of Veterans AffairsLGBT Health ProgramWashingtonUSA
  8. 8.Boston University School of MedicineBostonUSA
  9. 9.School of Social WorkBoston UniversityBostonUSA
  10. 10.Department of PsychologyUniversity of WindsorWindsorCanada

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