Archives of Sexual Behavior

, Volume 37, Issue 5, pp 763–772 | Cite as

Risk Reduction for HIV-Positive African American and Latino Men with Histories of Childhood Sexual Abuse

  • John K. Williams
  • Gail E. Wyatt
  • Inna Rivkin
  • Hema Codathi Ramamurthi
  • Xiaomin Li
  • Honghu Liu
Original Paper: Black And Latino Male Bisexualities Special Section


While the HIV epidemic has disproportionately affected African American and Latino men who have sex with men (MSM), few HIV prevention interventions have focused on African American and Latino men who have sex with both men and women (MSMW). Even fewer interventions target HIV-positive African American and Latino MSM and MSMW with histories of childhood sexual abuse (CSA), a population that may be vulnerable to high-risk sexual behaviors, having multiple sexual partners, and depression. The Men’s Health Project, a small randomized clinical trial, compared the effects of two 6-session interventions, the Sexual Health Intervention for Men (S-HIM), guided by social learning theory and aimed at decreasing high-risk sexual behaviors, number of sexual partners, and depressive symptoms, and a standard health promotion control (SHP). A community sample of 137 HIV-positive gay and non-gay identifying African American and Latino MSM and MSMW with histories of CSA was recruited. Results were based on an “intent to treat” analyses of baseline to post, 3 and 6 month follow-ups. The sample as a whole reported reductions in sexual risk behaviors and number of sexual partners from baseline to post-test, and from the 3 to 6 month follow-ups, although the decrease in sexual risk behavior from baseline to post-test was significant only for S-HIM participants. No significant differences between conditions were reported for depressive symptoms, but the total sample reported a significant decrease at 6 months. These findings highlight the importance of addressing sexual decision-making and psychological adjustment for ethnic men, while being sensitive to CSA histories and sexual minority status, and suggest the need to develop additional strategies to heighten HIV risk reduction over time.


African American Latino Homosexuality Bisexuality Childhood sexual abuse HIV 


  1. Agonick, G., O’Donnell, L., Stueve, A., San Doval, A., Durna, R., & Vargo, S. (2004). Sexual behaviors and risks among bisexually- and gay-identified young Latino Men. AIDS and Behavior, 8, 185–197.CrossRefGoogle Scholar
  2. Badgley, R., Allard, H., McCormick, N., Proudfoot, P., Fortin, D., Ogilvie, D., et al. (1984). Sexual offenses against children (Vol. 1). Ottawa: Canadian Government Publishing Center.Google Scholar
  3. Baker, A. W., & Duncan, S. P. (1985). Child sexual abuse: A study of prevalence in Great Britain. Child Abuse and Neglect, 9, 457–467.PubMedCrossRefGoogle Scholar
  4. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Upper Saddle River, NJ: Prentice-Hall.Google Scholar
  5. Bieschke, K. J., Perez, R. M., & DeBord, K. A. (Eds.). (2007). Handbook of counseling and psychotherapy with lesbian, gay, bisexual, and transgender clients (2nd ed., pp. 119–145). Washington, DC: American Psychological Association.Google Scholar
  6. Bingham, T. A., Harawa, N. T., Johnson, D. F., Secura, G. M., MacKellar, D. A., & Valleroy, L. A. (2003). The effect of partner characteristics on HIV infection among African American men who have sex with men in the Young Men’s Survey, Los Angeles, 1999–2000. AIDS Education and Prevention, 15(1 Suppl A), 39–52.PubMedCrossRefGoogle Scholar
  7. Burns-Loeb, T., Williams, J. K., Rivkin, I., Vargas Carmona, J., Wyatt, G., Chin, D., et al. (2002). The effects of child sexual abuse on adolescent and adult sexual functioning. Annual Review of Sex Research, 13, 307–345.Google Scholar
  8. Carballo-Dieguez, A., & Dolezal, C. (1994). Contrasting types of Puerto Rican men who have sex with men (MSM). Journal of Psychology and Human Sexuality, 6, 41–67.Google Scholar
  9. Carballo-Dieguez, A., Dolezal, C., Leu, C. S., Nieves, L., Diaz, F., Decena, F., et al. (2005). A randomized control trial to test an HIV prevention intervention for Latino gay and bisexual men: Lessons learned. AIDS Care, 17, 314–328.PubMedCrossRefGoogle Scholar
  10. Carballo-Dieguez, A., Dolezal, C., Nieves-Rosa, L., & Diaz, F. (2000). Similarities in the sexual behavior and HIV risk factors of Colombian, Dominican, Mexican, and Puerto Rican MSM residing in New York City. Journal of Psychology and Human Sexuality, 12(4), 49–67.CrossRefGoogle Scholar
  11. Centers for Disease Control and Prevention (CDC). (2001). HIV/AIDS surveillance report (year end edition No. 13, 2). Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar
  12. Centers for Disease Control and Prevention (CDC). (2002). HIV/AIDS among Hispanics in the United States [Factsheet]. CDC: Author.Google Scholar
  13. Centers for Disease Control and Prevention. (2003). HIV/STD risks in young men who have sex with men who do not disclose their sexual orientation, six US cities, 1994–2000. (Morbidity and Mortality Weekly Report No. 52). Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar
  14. Centers for Disease Control and Prevention. (2004). HIV/AIDS surveillance report, 2003 (Vol. 15). Atlanta: US Department of Health and Human Services, Center for Disease Control and Prevention.Google Scholar
  15. Centers for Disease Control and Prevention. (2005a). HIV/AIDS surveillance report, 2004 (Vol. 16). Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar
  16. Centers for Disease Control and Prevention. (2005b). HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men–Five US Cities, June 2004–April 2005. (Morbidity and Mortality Weekly Report No. 54). Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar
  17. Chesney, M. A., Chambers, D. B., Taylor, J. M., Johnson, L. M., & Folkman, S. (2003). Coping effectiveness training for men living with HIV: Results from a randomized clinical trial testing a group-based intervention. Psychosomatic Medicine, 65, 1038–1046.PubMedCrossRefGoogle Scholar
  18. Chin, D., Wyatt, G., Carmona, J., Loeb, T., & Myers, H. (2004). Child sexual abuse and HIV: An integrative risk-reduction approach. In L. J. Koenig & L. S. Doll (Eds.), From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention (pp. 233–250). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  19. Cole, C. H., & Barney, E. E. (1987). Safeguards and the therapeutic window: A group treatment strategy for adult incest survivors. American Journal of Orthopsychiatry, 57, 601–609.PubMedGoogle Scholar
  20. De Arellano, M. A., Waldrop, A. E., Deblinger, E., Cohen, J. A., Danielson, C. K., & Mannarino, A. R. (2005). Community outreach program for child victims of traumatic events: A community-based project for underserved populations. Behavior Modification, 29, 130–155.PubMedCrossRefGoogle Scholar
  21. Denning, P. H., & Campsmith, M. L. (2005). Unprotected anal intercourse among HIV-positive men who have a steady male sex partner with negative or unknown HIV serostatus. American Journal of Public Health, 95, 152–158.PubMedCrossRefGoogle Scholar
  22. Diaz, R. M. (1998). Latino gay men and HIV: Culture, sexuality and risk behavior. New York: Routledge.Google Scholar
  23. Diaz, R. M., Stall, R. D., Hoff, C., Daihle, D., & Coates, T. J. (1996). HIV risks among Latino gay men in the southwestern United States. AIDS Education and Prevention, 8, 415–429.PubMedGoogle Scholar
  24. Dodge, B., & Sandfort, T. G. M. (2007). A review of mental health research on bisexual individuals when compared to homosexual and heterosexual individuals. In B. A. Firestein (Ed.), Becoming visible: Counseling bisexuals across the lifespan (pp. 28–51). New York: Columbia University Press.Google Scholar
  25. Doll, L. S., Petersen, L. R., White, C. R., Johnson, E. S., Ward, J. W., & The Blood Study Donor Group. (1992). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. Journal of Sex Research, 29, 1–14.CrossRefGoogle Scholar
  26. 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 & Neglect, 14, 19–28.CrossRefGoogle Scholar
  27. Friedrich, W. N., Urquiza, A. J., & Beilke, R. (1986). Behavior problems in sexually abused young children. Journal of Pediatric Psychology, 11, 47–57.PubMedCrossRefGoogle Scholar
  28. Garnefski, N., & Arends, E. (1998). Sexual abuse and adolescent maladjustment: Differences between male and female victims. Journal of Adolescence, 21, 99–107.PubMedCrossRefGoogle Scholar
  29. Goldbaum, G., Perdue, T., Wolitski, R., Reitmeijer, C., Hedrich, A., Wood, R., et al. (1998). Differences in risk behavior and sources of AIDS information among gay, bisexual, and straight-identified men who have sex with men. AIDS and Behavior, 2, 13–21.CrossRefGoogle Scholar
  30. Gomez, C. A., Mason, B., & Alvarado N. J. (2005). Culture matters: The role of race and ethnicity in the sexual lives of HIV-positive gay, bisexual men. In P. Halkitis, C. Gomez, & R. J. Wolitski (Eds.), HIV+ sex: The psychological and interpersonal dynamics of HIV-seropositive gay and bisexual men’s relationships (pp. 87–100). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  31. Green, A. H. (1993). Child sexual abuse: Immediate and long-term effects and intervention. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 890–902.PubMedCrossRefGoogle Scholar
  32. Harawa, N. T., Williams, J. K., Ramamurthi, H. C., & Bingham, T. A. (2006). Perceptions towards condom use, sexual activity, and HIV disclosure among HIV-positive African American men who have sex with men: Implications for heterosexual transmission. Journal of Urban Health, 83, 682–694.PubMedCrossRefGoogle Scholar
  33. Heckman, T. G., Kelly, J. A., & Bogart, L. M. (1999). HIV risk differences between African American and white men who have sex with men. Journal of National Medical Association, 91, 92–100.Google Scholar
  34. Holmes, W. C., & Slap, G. B. (1998). Sexual abuse of boys: Definition, prevalence, correlates, sequelae, and management. Journal of the American Medical Association, 280, 1855–1862.PubMedCrossRefGoogle Scholar
  35. Icard, L. (1986). Black gay men and conflicting social identities: Sexual orientation versus racial identity. In J. Glipton & M. Valentich (Eds.), Social work practice in sexual problems (pp. 83–93). New York: Haworth Press.Google Scholar
  36. Jarama, S. L., Kennamer, J. D., Poppen, P. J., Hendricks, M., & Bradford, J. (2005). Psychosocial, behavioral and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men. AIDS and Behavior, 9, 513–523.PubMedCrossRefGoogle Scholar
  37. Kanouse, D. E., Bluthenthal, R. N., Bogart, L., Iguchi, M.Y., Perry, S., Sand, K., et al. (2005). Recruiting drug-using men who have sex with men into behavioral interventions: A two-stage approach. Journal of Urban Health, 82, i109–i119.PubMedGoogle Scholar
  38. Kegeles, S. M., Hays, R. B., & Coates, T. J. (1996). M-powerment Project: A community-level HIV prevention intervention for young gay men. American Journal of Public Health, 86, 1129–1136.PubMedCrossRefGoogle Scholar
  39. Kelly, J. A., Murphy, D. A., Sikkema, K. J., McAuliffe, T. L., Roffman, R. A., Solomon, L. J., et al. (1997). Randomized, controlled, community-level HIV-prevention for sexual-risk behavior among homosexual men in US cities. Lancet, 350, 1500–1505.PubMedCrossRefGoogle Scholar
  40. King, J. L. (2004). On the down low: A journey into the lives of ‘straight’ Black men who sleep with men. New York: Random House.Google Scholar
  41. Koenig, L. J., Doll, L. S., O’Leary, A., & Pequegnat, W. (Eds.). (2003). From child sexual abuse to adult sexual risk: Trauma, revictimization, and intervention. Washington, DC: American Psychological Association Press.Google Scholar
  42. Kraft, J. M., Beeker, C., Stokes, J. P., & Peterson, J. L. (2000). Finding the “community” in community-level HIV/AIDS interventions: Formative research with young African American men who have sex with men. Health Education and Behavior, 27, 430–441.PubMedCrossRefGoogle Scholar
  43. Malebranche, D. (2003). Black men who have sex with men and the HIV epidemic: Next steps for public health. American Journal of Public Health, 93, 862–865.PubMedGoogle Scholar
  44. Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men? Journal of Black Psychology, 30, 78–105.CrossRefPubMedGoogle Scholar
  45. McCarty, T., Roberts, L. W., & Hendrickson, K. (1996). Urologic sequelae of childhood genitourinary trauma and abuse in men: Principles of recognition with fifteen case illustrations. Urology, 47, 617–621.PubMedCrossRefGoogle Scholar
  46. Miller, R. L. (1995). Assisting gay men to maintain safer sex: An evaluation of an AIDS service organization’s safer sex maintenance program. AIDS Education & Prevention, 7, 48–63.Google Scholar
  47. Miller, M., Serner, M., & Wagner, M. (2005). Sexual diversity among Black men who have sex with men in an inner-city community. Journal of Urban Health, 82(1 Suppl 1), i26–34.PubMedGoogle Scholar
  48. Millett, G., Malebranche, D., Mason, B., & Spikes, P. (2005). Focusing “down low”: Bisexual Black men, HIV risk and heterosexual transmission. Journal of the National Medical Association, 97, 52S–59S.PubMedGoogle Scholar
  49. Montgomery, J. P., Mokotoff, E. D., Gentry, A. C., & Blair, J. M. (2003). The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care, 15, 829–837.PubMedCrossRefGoogle Scholar
  50. Patterson, T. L., Shaw, W. S., & Semple, S. J. (2003). Reducing the sexual risk behaviors of HIV positive individuals: Outcome of a randomized controlled trial. Annals of Behavioral Medicine, 25, 137–145.PubMedCrossRefGoogle Scholar
  51. 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 & Neglect, 25, 557–584.CrossRefGoogle Scholar
  52. Peterson, J. L., Coates, T. J., Catania, J., Hauck, W. W., Acree, M., Daigle, D., et al. (1996). Evaluation of an HIV risk reduction intervention among African-American homosexual and bisexual men. AIDS, 10, 319–325.PubMedCrossRefGoogle Scholar
  53. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  54. Remien, R. H., Wagner, G., Dolezal, C., & Carballo-Dieguez, A. (2001). Factors associated with HIV sexual risk behavior in male couples of mixed HIV status. Journal of Psychology & Human Sexuality, 13, 31–48.CrossRefGoogle Scholar
  55. Ruggiero, K. J., McLeer, S. V., & Dixon, J. F. (2000). Sexual abuse characteristics associated with survivor psychopathology. Child Abuse & Neglect, 24, 951–964.CrossRefGoogle Scholar
  56. Stokes, J. P., & Peterson, J. L. (1998). Homophobia, self-esteem, and risk for HIV among African American men who have sex with men. AIDS Education and Prevention, 10, 278–292.PubMedGoogle Scholar
  57. Tebbutt, J., Swanston, H., Oates, R. K., & O’Toole, B. I. (1997). Five years after child sexual abuse: Persisting dysfunction and problems of prediction. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 330–339.PubMedCrossRefGoogle Scholar
  58. Tjaden, P., & Thoennes, N. (2000). Prevalence and consequences of male-to-female and female-to-male intimate partner violence as measured by the National Violence Against Women Survey. Violence Against Women, 6, 142–161.CrossRefGoogle Scholar
  59. Watkins, B., & Bentovim, A. (1992). The sexual abuse of male children and adolescents: A review of current research. Journal of Child Psychology and Psychiatry, 33, 197–248.PubMedCrossRefGoogle Scholar
  60. West, C. M., Williams, L. M., & Siegel, J. A. (2000). Adult sexual re-victimization among Black women sexually abuse in childhood: A prospective examination of serious consequences of abuse. Child Maltreatment, 5, 49–57.PubMedCrossRefGoogle Scholar
  61. Williams, J. K., Wyatt, G. E., Resell, J., Peterson, J., & Asuan O’Brien, A. (2004). Psychosocial influences on HIV risks among HIV-positive African American and Latino MSM with a history of CSA. Cultural Diversity & Ethnic Minority Psychology, 10, 268–286.CrossRefGoogle Scholar
  62. Wolitski, R. J., Gomez, C. A., Parsons, J. T., & the SUMIT Study Group. (2005). Effect of a peer-led behavioral intervention to reduce HIV transmission and promote serostatus disclosure among HIV-seropositive gay and bisexual men. AIDS, 19(Suppl. 1), S99–S109.PubMedCrossRefGoogle Scholar
  63. Wyatt, G. E. (1984). The Wyatt sex history questionnaire. Los Angeles: University of California at Los Angeles.Google Scholar
  64. Wyatt, G. E. (1985). The sexual abuse of Afro-American and White-American women in childhood. Child Abuse and Neglect, 9, 507–519.PubMedCrossRefGoogle Scholar
  65. Wyatt, G. E., Guthrie, D., & Notgrass, C. M. (1992). Differential effects of women’s child sexual abuse and subsequent sexual revictimization. Journal of Consulting and Clinical Psychology, 60, 167–173.PubMedCrossRefGoogle Scholar
  66. Wyatt, G. E., Longshore, D., Chin, D., Carmona, J. C., Loeb, T. B., Myers, H. F., et al. (2004). The efficacy of an integrated risk reduction Intervention for HIV-positive women with child sexual abuse histories. AIDS and Behavior, 8, 453–462.PubMedCrossRefGoogle Scholar
  67. Wyatt, G. E., Rivkin, I., Loeb, T. B., Carmona, J. V., Chin, D., Liu, H., et al. (2006). The effects of a risk reduction intervention for HIV-positive women with histories of child sexual abuse: A longitudinal study. Manuscript submitted for publication.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • John K. Williams
    • 1
  • Gail E. Wyatt
    • 1
  • Inna Rivkin
    • 2
  • Hema Codathi Ramamurthi
    • 1
  • Xiaomin Li
    • 1
  • Honghu Liu
    • 3
  1. 1.Department of Psychiatry and Biobehavioral Sciences, Semel Institute of Neuroscience & Human BehaviorUniversity of California, Los AngelesLos AngelesUSA
  2. 2.Department of PsychologyUniversity of Alaska FairbanksFairbanksUSA
  3. 3.Department of General Internal Medicine and Health Services ResearchUniversity of California, Los AngelesLos AngelesUSA

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