Relf Michael V, Huang Bu, Campbell Jacquelyn, Catania Joe
Department of Professional Nursing, Georgetown University School of Nursing and Health Studies, Washington, D.C., USA.
J Assoc Nurses AIDS Care. 2004 Mar-Apr;15(2):14-26. doi: 10.1177/1055329003261965.
The highest absolute number of new HIV infections and AIDS cases still occur among men who have sex with men (MSM). Numerous theoretical approaches have been used to understand HIV risk behaviors among MSM; however, no theoretical model examines sexual risk behaviors in the context of gay identity and interpersonal violence. Using a model testing predictive correlational design, the theoretical relationships between childhood sexual abuse, adverse early life experiences, gay identity, substance use, battering, aversive emotions, HIV alienation, cue-to-action triggers, and HIV risk behaviors were empirically tested using confirmatory factor analysis and structural equation modeling. The relationships between these constructs are complex, yet childhood sexual abuse and gay identity were found to be theoretically associated with HIV risk behaviors. Also of importance, battering victimization was identified as a key mediating variable between childhood sexual abuse, gay identity, and adverse early life experiences and HIV risk behaviors among urban MSM.
男男性行为者（MSM）中新增艾滋病毒感染和艾滋病病例的绝对数量仍然最高。人们运用了许多理论方法来理解男男性行为者的艾滋病毒风险行为；然而，没有任何理论模型在同性恋身份和人际暴力的背景下审视性风险行为。采用模型测试预测相关设计，运用验证性因素分析和结构方程模型对童年期性虐待、早期不良生活经历、同性恋身份、物质使用、殴打、厌恶情绪、艾滋病毒疏离感、行动提示触发因素和艾滋病毒风险行为之间的理论关系进行了实证检验。这些构念之间的关系很复杂，但研究发现童年期性虐待和同性恋身份在理论上与艾滋病毒风险行为相关。同样重要的是，在城市男男性行为者中，殴打受害者被确定为童年期性虐待、同性恋身份、早期不良生活经历与艾滋病毒风险行为之间的关键中介变量。
