Arreola Sonya, Neilands Torsten, Pollack Lance, Paul Jay, Catania Joseph
HIV Research Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
J Sex Res. 2008 Jul-Sep;45(3):246-52. doi: 10.1080/00224490802204431.
Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.
在美国，男同性恋者和双性恋男性承受着艾滋病毒感染的负担，且童年期遭受性虐待的比例很高，而这种经历会对感染艾滋病毒及其他健康状况产生预示作用。本研究在一个与男性发生性关系的成年男性概率样本中，考察了被迫、自愿以及无童年期性经历对健康状况的不同影响。被迫性行为组的心理困扰、物质使用及感染艾滋病毒风险水平最高。自愿性行为组和无性经历组在抑郁率和自杀意念方面没有差异。自愿性行为组和被迫性行为组在物质使用和传播风险方面比无性经历组更高。然而，被迫性行为组在频繁吸毒和高危性行为方面的发生率显著高于自愿性行为组。研究结果表明，被迫的童年期性经历会导致比自愿或无童年期性经历更高的风险状况，被迫和自愿的童年期性经历之间的风险模式有所不同，维持风险模式的潜在机制可能也存在差异。明确被迫和自愿性行为组不同的风险模式及其维持机制非常重要，这样干预措施才能针对与每种经历相关的特定轨迹进行调整。
