Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, South Carolina, USA.
Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, South Carolina, USA.
AIDS Behav. 2024 Oct;28(10):3421-3429. doi: 10.1007/s10461-024-04438-4. Epub 2024 Jul 11.
Childhood sexual abuse (CSA) continues to be a public health challenge. The prevalence of experiencing CSA is higher among men who have sex with men (MSM) than the general population. CSA has been linked to compulsive sexual behavior (CSB) among varying populations but has not been examined among MSM who were newly diagnosed with HIV. Therefore, the aims of this study were to assess the direct association between CSA and CSB among newly diagnosed MSM living with HIV, and to identify the potential mediating roles of depressive symptoms and emotion regulation in the association between CSA and CSB. The study was a secondary data analysis using data obtained from 2012 to 2017 from two community HIV clinics in New York City (n = 202). CSA was operationalized with questions asking about sexual abuse during childhood/adolescence. CSB was measured using the 13-item Compulsive Sexual Behavior Inventory (CSBI). Depressive symptoms were measured using the 20-item Centers for Epidemiologic Studies Depression (CES-D) scale and emotion regulation was measured using a 36-item Difficulties in Emotion Regulation Scale (DERS). Path analysis was conducted to determine the mediating role of depressive symptoms and emotion regulation in the association between CSA and CSB. There was a statistically significant association between CSA and CSB (β = 0.160; p = 0.019). There were statistically significant indirect associations between CSA, depressive symptoms, emotion regulation, and CSB (depressive symptoms β = 0.0.071; p = 0.010; DERS: β = 0.080; p = 0.006). Depressive symptoms were also correlated with emotion regulation (r = 0.596; p < 0.001). The relationship between CSA and CSB was significantly mediated by depressive symptoms and emotion regulation. Trauma-informed interventions addressing depressive symptoms and difficulties in emotion regulation may help to reduce CSB among MSM living with HIV.
儿童期性虐待（CSA）仍然是一个公共卫生挑战。男男性行为者（MSM）经历 CSA 的患病率高于一般人群。CSA 与不同人群中的强迫性行为（CSB）有关，但尚未在新诊断为 HIV 的 MSM 中进行检查。因此，本研究旨在评估新诊断为 HIV 的 MSM 中 CSA 与 CSB 之间的直接关联，并确定抑郁症状和情绪调节在 CSA 与 CSB 之间关联中的潜在中介作用。这项研究是对 2012 年至 2017 年期间从纽约市两家社区 HIV 诊所获得的数据进行的二次数据分析（n=202）。CSA 通过询问童年/青春期性虐待的问题来操作化。CSB 使用 13 项强迫性行为检查表（CSBI）进行测量。抑郁症状使用 20 项流行病学研究抑郁量表（CES-D）进行测量，情绪调节使用 36 项情绪调节困难量表（DERS）进行测量。路径分析用于确定抑郁症状和情绪调节在 CSA 与 CSB 之间的关联中的中介作用。CSA 与 CSB 之间存在统计学显著关联（β=0.160；p=0.019）。CSA、抑郁症状、情绪调节与 CSB 之间存在统计学显著的间接关联（抑郁症状β=0.0.071；p=0.010；DERS：β=0.080；p=0.006）。抑郁症状与情绪调节也呈正相关（r=0.596；p<0.001）。CSA 与 CSB 之间的关系主要由抑郁症状和情绪调节介导。针对抑郁症状和情绪调节困难的创伤知情干预措施可能有助于减少 HIV 感染者中 CSB 的发生。
