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LGBTQ 人群中潜在创伤性事件与性风险行为的心理社会风险模型。

A Psychosocial Risk Model of Potentially Traumatic Events And Sexual Risk Behavior Among LGBTQ Individuals.

机构信息

Center for Interdisciplinary Research on AIDS, Yale University , New Haven , CT , USA.

Department of Psychology, City College of New York, City University of New York (CUNY) , New York , NY , USA.

出版信息

J Trauma Dissociation. 2019 Oct-Dec;20(5):603-618. doi: 10.1080/15299732.2019.1597815. Epub 2019 Apr 1.

Abstract

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals face heightened risk of potentially traumatic events (PTEs) exposure, including hate crimes and childhood abuse. Past research demonstrates associations between PTEs exposure and sexual risk behavior; however, examining the indirect effect of PTEs on sexual risk behavior remains understudied among LGBTQ individuals. This study tested a path analysis model to inform interventions targeted to reduce sexual risk behavior, as conceptualized by condomless sex with casual partners without knowing the person's HIV or sexually transmitted infection (STI) status, among LGBTQ individuals with PTEs exposure. Participants completed an online one-time survey and included 207 LGBTQ adults who experienced at least one PTE during the past year. Indirect effect results indicated that PTEs exposure was related to sexual risk behavior through serial associations between shame, loneliness, and substance use. Direct effect estimates indicated that greater PTEs exposure was associated with greater shame, loneliness, substance use, and sexual risk behavior. Greater shame was associated with greater loneliness, which was associated with greater substance use. Also, greater substance use was associated with greater sexual risk behavior. This study adds to the burgeoning body of literature on the relationship between PTEs exposure and sexual risk behavior among LGBTQ individuals. Clinical and counseling interventions for LGBTQ individuals with PTEs exposure should work to address modifiable psychosocial risk factors associated with sexual risk behavior.

摘要

女同性恋、男同性恋、双性恋、跨性别和酷儿(LGBTQ)群体面临更高的潜在创伤性事件(PTE)暴露风险,包括仇恨犯罪和儿童虐待。过去的研究表明,PTE 暴露与性风险行为之间存在关联;然而,在 LGBTQ 群体中,研究 PTE 对性风险行为的间接影响仍然不足。本研究通过路径分析模型检验了一种理论假设,即在经历过至少一次 PTE 的 LGBTQ 个体中,PTE 暴露通过羞耻感、孤独感和物质使用之间的一系列关联,对不使用安全套与偶然伴侣发生性关系且不了解对方 HIV 或性传播感染 (STI) 状态的性行为风险产生间接影响。参与者完成了一次性在线调查,包括 207 名在过去一年中经历过至少一次 PTE 的 LGBTQ 成年人。间接效应结果表明,PTE 暴露通过羞耻感、孤独感和物质使用之间的一系列关联与性行为风险相关。直接效应估计表明,PTE 暴露程度越高,羞耻感、孤独感、物质使用和性行为风险越高。更大的羞耻感与更大的孤独感相关,而更大的孤独感与更大的物质使用相关。此外,更大的物质使用与更大的性行为风险相关。本研究增加了关于 LGBTQ 群体中 PTE 暴露与性行为风险之间关系的文献。针对经历过 PTE 的 LGBTQ 个体的临床和咨询干预措施应致力于解决与性行为风险相关的可改变的心理社会风险因素。

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