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Posttraumatic Cognitions and Condomless Sex Among Men Who Have Sex with Men (MSM) with a History of Childhood Sexual Abuse: The Role of Avoidance Coping

AIDS and Behavior volume 27, pages 667–672 (2023)Cite this article

Abstract

This study explicated associations between trauma-related cognitions and condomless sex, examining avoidance coping style and behavior (i.e., substance use) as intermediate variables, among a group disproportionately affected by both trauma and HIV. Two hundred and ninety HIV-negative MSM with a history of childhood sexual abuse (CSA) completed a cross-sectional psychosocial battery. Trauma-related cognitions were positively associated with more acts of condomless sex. Indirect associations on condomless sex were driven by avoidance coping, but not substance use. Findings indicate a need to address trauma-related cognitions and avoidance coping within interventions for reducing HIV risk among MSM with a history of CSA.

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Data Availability

The data and code are accessible on request from the principal investigator.

References

  1. Mimiaga MJ, Noonan E, Donnell D, Safren SA, Koenen KC, Gortmaker S, et al. Childhood sexual abuse is highly associated with HIV risk-taking behavior and infection among MSM in the EXPLORE Study. J Acquir Immune Defic Syndr. 2009;51(3):340–8.

    Article  Google Scholar 

  2. O’Cleirigh C, Safren SA, Mayer KH. The pervasive effects of childhood sexual abuse: challenges for improving HIV prevention and treatment interventions. J Acquir Immune Defic Syndr. 2012;59(4):331–4.

    Article  Google Scholar 

  3. Sweet T, Welles SL. Associations of sexual identity or same-sex behaviors with history of childhood sexual abuse and HIV/STI risk in the United States. J Acquir Immune Defic Syndr. 2012;59(4):400–8.

    Article  Google Scholar 

  4. Lloyd S, Operario D. HIV risk among men who have sex with men who have experienced childhood sexual abuse: systematic review and meta-analysis. AIDS Educ Prev. 2012;24(3):228–41.

    Article  Google Scholar 

  5. O’Cleirigh C, Safren SA, Taylor SW, Goshe BM, Bedoya CA, Marquez SM, et al. 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. AIDS Behav. 2019;23(9):2421–31.

    Article  Google Scholar 

  6. Collin-Vezina D, Daigneault I, Hebert M. Lessons learned from child sexual abuse research: prevalence, outcomes, and preventive strategies. Child Adolesc Psychiatry Ment Health. 2013;7(1):22.

    Article  Google Scholar 

  7. Batchelder AW, Moskowitz JT, Jain J, Cohn M, Earle MA, Carrico AW. A novel technology-enhanced internalized stigma and shame intervention for HIV-positive persons with substance use disorders. Cogn Behav Pract. 2020;27(1):55-69.

    Article  Google Scholar 

  8. Foa EB, Ehlers A, Clark DM, Tolin DF, Orsillo SM. The Posttraumatic Cognitions Inventory (PTCI): development and validation. Psychol Assess. 1999;11(3):303–14.

    Article  Google Scholar 

  9. Yi H, Sandfort TG, Shidlo A. Effects of disengagement coping with HIV risk on unprotected sex among HIV-negative gay men in New York City. Health Psychol. 2010;29(2):205–14.

    Article  Google Scholar 

  10. Batchelder AW, Safren SA, Coleman JN, Boroughs MS, Thiim A, Ironson GH, et al. Indirect effects from childhood sexual abuse severity to PTSD: the role of avoidance coping. J Interpers Viol. 2021;36(9–10):5476–95.

    Article  Google Scholar 

  11. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33.

    Google Scholar 

  12. Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92–100.

    Article  CAS  Google Scholar 

  13. Coleman JN, Batchelder AW, Kirakosian N, Choi KW, Shipherd JC, Bedoya CA, et al. Indirect effects of dissociation on the relationship between lifetime PTSD symptoms and condomless sex among men who have sex with men with a history of childhood sexual abuse. J Trauma Dissoc. 2021;23:1–17.

    Google Scholar 

  14. Hayes AF, Montoya AK, Rockwood NJ. The analysis of mechanisms and their contingencies: PROCESS versus structural equation modeling. Australas Mark J. 2017;25(1):76–81.

    Article  Google Scholar 

  15. Herta DC, Nemes B, Cozman D. Cognitive appraisal of exposure to specific types of trauma—a study of gender differences. BMC Womens Health. 2017;17(1):1–10.

    Article  Google Scholar 

  16. Crepaz N, Marks G. Towards an understanding of sexual risk behavior in people living with HIV: a review of social, psychological, and medical findings. AIDS. 2002;16(2):135–49.

    Article  Google Scholar 

  17. Whiffen VE, MacIntosh HB. Mediators of the link between childhood sexual abuse and emotional distress: a critical review. Trauma Viol Abuse. 2005;6(1):24–39.

    Article  Google Scholar 

Download references

Acknowledgements

We wish to thank the participants involved in this research study.

Funding

This work was supported by NIMH (Grant No. R01MH095624, PI Dr. Conall O’Cleirigh). Dr. Daniel Hall’s time was supported by NCCIH (Grant No. K23AT010157). Dr. Abigail Batchelder’s time was supported by NIDA (Grant No. K23DA043418). Dr. Calvin Fitch’s and Dr. Tiffany Glynn's time was supported by NIAID T32AI007433 (PI: Kenneth Freedberg). Drs. Safren and Ironson were also supported by 1P30MH116867 for author time.

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Authors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Daniel L. Hall, Abigail W. Batchelder, Calvin J. Fitch, Tiffany R. Glynn, Helen Mizrach & Conall O’Cleirigh

  2. Harvard Medical School, Boston, MA, USA

    Daniel L. Hall, Abigail W. Batchelder, Calvin J. Fitch, Tiffany R. Glynn & Conall O’Cleirigh

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

    Abigail W. Batchelder, Calvin J. Fitch, Tiffany R. Glynn & Conall O’Cleirigh

  4. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Tiffany R. Glynn, Gail Ironson & Steven A. Safren

  5. Mongan Institute, 100 Cambridge St., 16th floor, MB, 02114, Boston, USA

    Daniel L. Hall

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  1. Daniel L. Hall
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  2. Abigail W. Batchelder
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  7. Steven A. Safren
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  8. Conall O’Cleirigh
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Contributions

DLH: Conceptualization, Formal Analysis, Writing original draft. AWB: Formal Analysis, Writing original draft, review, and editing. CJF: Writing original draft, review, and editing. TRG: Writing original draft, review, and editing. GI: Investigation, Resources, Writing review and editing. HM: Project administration, Writing review and editing. SAS: Investigation, Resources, Writing review and editing. COC: Conceptualization, Formal Analysis, Funding acquisition, Investigation, Resources, Writing review and editing. All the authors agreed for the final version to be submitted for peer review and possible publication.

Corresponding author

Correspondence to Daniel L. Hall.

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The authors declare no conflicts of interest.

Ethical Approval

IRB approval was granted by all participating institutions, including Fenway Health, Massachusetts General Hospital, and the University of Miami.

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All participants provided informed consent.

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Hall, D.L., Batchelder, A.W., Fitch, C.J. et al. Posttraumatic Cognitions and Condomless Sex Among Men Who Have Sex with Men (MSM) with a History of Childhood Sexual Abuse: The Role of Avoidance Coping. AIDS Behav 27, 667–672 (2023). https://doi.org/10.1007/s10461-022-03801-7

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Keywords

  • Men who have sex with men
  • HIV
  • Trauma
  • Coping
  • Avoidance