The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India
Abstract Background Childhood sexual abuse (CSA) is a significant global public health problem, which is associated with negative psychosocial outcomes and high-risk sexual behaviors in adults. Men who have sex with men (MSM) often report higher prevalence of CSA history than the general population,...
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doaj-9fec44521a6a4fca9f0b5152a01c17c42020-11-24T21:50:01ZengBMCBMC Public Health1471-24582016-08-0116111410.1186/s12889-016-3446-6The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in IndiaCecilia Tomori0Allison M. McFall1Aylur K. Srikrishnan2Shruti H. Mehta3Nymisha Nimmagadda4Santhanam Anand5Canjeevaram K. Vasudevan6Suniti Solomon7Sunil S. Solomon8David D. Celentano9Department of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthYR Gaitonde Centre for AIDS Research and EducationDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthJohns Hopkins Krieger School of Arts and SciencesYR Gaitonde Centre for AIDS Research and EducationYR Gaitonde Centre for AIDS Research and EducationYR Gaitonde Centre for AIDS Research and EducationDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthAbstract Background Childhood sexual abuse (CSA) is a significant global public health problem, which is associated with negative psychosocial outcomes and high-risk sexual behaviors in adults. Men who have sex with men (MSM) often report higher prevalence of CSA history than the general population, and CSA may play a key role in MSM’s greater vulnerability to HIV. Methods This study examined the prevalence of CSA history and its impact on the number of recent HIV-related risk behaviors (unprotected anal intercourse, high number of male and female sexual partners, alcohol use, drug use, and sex work in prior 6 months) and lifetime risk behaviors and experiences (high number of lifetime male and female sexual partners, early sexual debut, injection drug use, sex work, and intimate partner violence) among 11,788 adult MSM recruited via respondent driven sampling across 12 sites in India, with additional insights from thematic analysis of qualitative research with 363 MSM from 15 sites. Results Nearly a quarter (22.4 %) of participants experienced CSA, with substantially higher prevalence of CSA in the South and among kothis (feminine sexual identity). Qualitative findings revealed that older, trusted men may target young and, especially, gender nonconforming boys, and perpetrators’ social position facilitates nondisclosure. CSA may also initiate further same-sex encounters, including sex work. In multivariable analysis, MSM who experienced CSA had 21 % higher rate of recent (adjusted rate ratio [aRR = 1.21], 95 % confidence interval [CI]: 1.14–1.28), and 2.0 times higher lifetime (aRR = 2.04, 95 % CI: 1.75–2.38) HIV-related behaviors/experiences compared with those who did not. Conclusion This large, mixed-methods study found high overall prevalence of CSA among MSM (22.4 %), with substantially higher prevalence among MSM residing in the South and among more feminine sexual identities. Qualitative findings highlighted boys’ vulnerabilities to CSA, especially gender nonconformity, and CSA’s role in further sexual encounters, including sex work. Additionally, CSA was associated with an elevated rate of recent, and an even higher rate of lifetime HIV-related risk factors. Our results suggest an acute need for the development of CSA prevention interventions and the integration of mental health services for MSM with histories of CSA as part of HIV-prevention efforts.http://link.springer.com/article/10.1186/s12889-016-3446-6Childhood sexual abuseHIVRisk-behaviorsGender nonconformityMen who have sex with menIndia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Cecilia Tomori Allison M. McFall Aylur K. Srikrishnan Shruti H. Mehta Nymisha Nimmagadda Santhanam Anand Canjeevaram K. Vasudevan Suniti Solomon Sunil S. Solomon David D. Celentano |
spellingShingle |
Cecilia Tomori Allison M. McFall Aylur K. Srikrishnan Shruti H. Mehta Nymisha Nimmagadda Santhanam Anand Canjeevaram K. Vasudevan Suniti Solomon Sunil S. Solomon David D. Celentano The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India BMC Public Health Childhood sexual abuse HIV Risk-behaviors Gender nonconformity Men who have sex with men India |
author_facet |
Cecilia Tomori Allison M. McFall Aylur K. Srikrishnan Shruti H. Mehta Nymisha Nimmagadda Santhanam Anand Canjeevaram K. Vasudevan Suniti Solomon Sunil S. Solomon David D. Celentano |
author_sort |
Cecilia Tomori |
title |
The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India |
title_short |
The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India |
title_full |
The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India |
title_fullStr |
The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India |
title_full_unstemmed |
The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India |
title_sort |
prevalence and impact of childhood sexual abuse on hiv-risk behaviors among men who have sex with men (msm) in india |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2016-08-01 |
description |
Abstract Background Childhood sexual abuse (CSA) is a significant global public health problem, which is associated with negative psychosocial outcomes and high-risk sexual behaviors in adults. Men who have sex with men (MSM) often report higher prevalence of CSA history than the general population, and CSA may play a key role in MSM’s greater vulnerability to HIV. Methods This study examined the prevalence of CSA history and its impact on the number of recent HIV-related risk behaviors (unprotected anal intercourse, high number of male and female sexual partners, alcohol use, drug use, and sex work in prior 6 months) and lifetime risk behaviors and experiences (high number of lifetime male and female sexual partners, early sexual debut, injection drug use, sex work, and intimate partner violence) among 11,788 adult MSM recruited via respondent driven sampling across 12 sites in India, with additional insights from thematic analysis of qualitative research with 363 MSM from 15 sites. Results Nearly a quarter (22.4 %) of participants experienced CSA, with substantially higher prevalence of CSA in the South and among kothis (feminine sexual identity). Qualitative findings revealed that older, trusted men may target young and, especially, gender nonconforming boys, and perpetrators’ social position facilitates nondisclosure. CSA may also initiate further same-sex encounters, including sex work. In multivariable analysis, MSM who experienced CSA had 21 % higher rate of recent (adjusted rate ratio [aRR = 1.21], 95 % confidence interval [CI]: 1.14–1.28), and 2.0 times higher lifetime (aRR = 2.04, 95 % CI: 1.75–2.38) HIV-related behaviors/experiences compared with those who did not. Conclusion This large, mixed-methods study found high overall prevalence of CSA among MSM (22.4 %), with substantially higher prevalence among MSM residing in the South and among more feminine sexual identities. Qualitative findings highlighted boys’ vulnerabilities to CSA, especially gender nonconformity, and CSA’s role in further sexual encounters, including sex work. Additionally, CSA was associated with an elevated rate of recent, and an even higher rate of lifetime HIV-related risk factors. Our results suggest an acute need for the development of CSA prevention interventions and the integration of mental health services for MSM with histories of CSA as part of HIV-prevention efforts. |
topic |
Childhood sexual abuse HIV Risk-behaviors Gender nonconformity Men who have sex with men India |
url |
http://link.springer.com/article/10.1186/s12889-016-3446-6 |
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