Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, United States.
Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, United States.
Child Abuse Negl. 2020 Sep;107:104627. doi: 10.1016/j.chiabu.2020.104627. Epub 2020 Jul 16.
Adverse Childhood Experiences (ACEs) are associated with a wide range of increased risk behaviors and health consequences, they have not been extensively described in all subpopulations.
The specific objectives of the study were to describe the prevalence of predefined ACEs among a nationwide sample of men who have sex with men (MSM) and determine associated HIV or sexually transmitted infection (STI) related health outcomes, testing practices, and risk behaviors.
Eligible participants were MSM aged 18 years or older who reported male-male sex in the past 12 months.
Data were obtained from the 2015 cycle of the American Men's Internet Survey, these data were collected between September 2015 and April 2016, and contained questions related to 8 ACE exposure categories. During analyses conducted between September 2017 and April 2018, multiple log-binomial models were fit to assess associations.
Among 2590 participants, 79.7 % reported exposure to one or more ACE category. Participants exposed to any ACE were more likely to report STI testing (adjusted prevalence ratio [aPR]: 1.07; 95 % confidence interval [95 %-CI]: 1.00, 1.15), illicit substance use (aPR: 1.23, 95 %-CI: 1.05, 1.46), and condomless anal intercourse with another man (aPR: 1.13, 95 %-CI: 1.03, 1.21).
There is a high overall ACE burden among MSM nationally, with potential influences on key HIV/STI behaviors in later life. ACE exposure should be routinely assessed, prevention is ideal but appropriate measures such as trauma informed care should also be considered for adult MSM accessing HIV and STI-related services.
不良的童年经历（ACEs）与广泛的风险行为增加和健康后果相关，但在所有亚人群中并未广泛描述。
本研究的具体目的是描述全国范围内男男性行为者（MSM）中预先定义的 ACE 的流行率，并确定与 HIV 或性传播感染（STI）相关的健康结局、检测实践和风险行为的关联。
符合条件的参与者是年龄在 18 岁或以上，在过去 12 个月内报告有男性间性行为的 MSM。
数据来自于 2015 年美国男性互联网调查的周期，这些数据是在 2015 年 9 月至 2016 年 4 月之间收集的，包含了与 8 个 ACE 暴露类别相关的问题。在 2017 年 9 月至 2018 年 4 月进行的分析中，使用了多个对数二项式模型来评估关联。
在 2590 名参与者中，79.7%报告暴露于一个或多个 ACE 类别。暴露于任何 ACE 的参与者更有可能报告 STI 检测（调整后的患病率比 [aPR]：1.07；95%置信区间 [95%CI]：1.00，1.15）、非法药物使用（aPR：1.23，95%CI：1.05，1.46）和与另一名男性无保护肛交（aPR：1.13，95%CI：1.03，1.21）。
全国范围内 MSM 的 ACE 负担总体较高，对后期生活中的关键 HIV/STI 行为有潜在影响。应常规评估 ACE 暴露情况，预防是理想的，但也应考虑为接受 HIV 和 STI 相关服务的成年 MSM 提供创伤知情护理等适当措施。
