| Learning Objective #1: Describe the outcomes of childhood sexual abuse among urban men who have sex with men | |||
| Learning Objective #2: Describe the antecedents and outcomes of intimate partner violence among urban men who have sex with men |
Theory Generation: Although numerous theoretical approaches have been utilized in conducting HIV risk behavior research, no theoretical model used in HIV prevention research examines the experience of interpersonal violence and gay identity among MSM. Therefore, a middle-range theory placing sexual risk behaviors in the context and lives of MSM was developed based on a theory synthesis.
Methods: Using a model testing predictive correlational design, the proposed model was cross-validated in two probability samples of urban MSM. Using confirmatory factor analysis and structural equation modeling, the theoretical relationships and path structures of the proposed theoretical model were tested.
Results: Childhood sexual abuse and intimate partner violence are prevalent problems for urban MSM. Childhood sexual abuse and gay identity are significant predictors of HIV risk behaviors in MSM. As hypothesized, aversive emotions and victimization by an intimate partner mediate the relationship between childhood sexual abuse and HIV risk behavior. Similarly, aversive emotions, substance use, intimate partner violence, and HIV alienation also mediate the relationship between gay identity and HIV risk behaviors. As theoretically hypothesized, cue-to-action triggers (knowing someone with HIV or caring for someone with AIDS) was a protective mediator between gay identity and HIV risk behaviors.
Conclusions: This study has demonstrated the importance of childhood sexual abuse, gay identity and victimization by an intimate partner as causal factors related to HIV risk behaviors in urban MSM. Additionally, the tested theoretical model has significant potential as a middle-range theory of HIV risk for MSM examining and identifying important causal associations not previously investigated.