[health menu] XI International Conference on AIDS
July 7-12, 1996

Strathdee Steffanie A., Hogg R.S., Martindale S.L.,
Cornelisse P.G.A., Craib K.J.P., Schilder A.,
Montaner J.S.G., O'Shaughnessy M.V. and Schechter M.T.
the Vanguard Project
B.C. Centre for Excellence in HIV/AIDS
and UniversIty of British Columbia
Vancouver, B.C., Canada


Sexual Abuse is an Independent Predictor for Sexual Risk-Taking Among Young HIV-Negative Gay Men: Results From a Prospective Study at Baseline


To identify predictors of sexual risk-taking among young HIV-negative men having sex with men (MSM) enrolled in a prospective study of HIV-1 incidence and associated risk factors in Vancouver, Canada.


MSM aged 18-30 who had not previously tested HIV+ were recruited through physicians, clinics and outreach, and completed a baseline questionnaire and underwent an HIV test. Data collected included demographics, social support, depression (7-item CES-D), substance use, consensual sex with men and women, paid sex and non-consensual sex (NCS). The latter was defined as "any type of sexual activity (oral, anal, vaginal) that you were forced or coerced into" under age 12, between 12-17 years, or >18 years. For the purposes of this analysis, risk-takers (RT) were defined as men who had 1 casual male sex partner (<once per month) in the last year with whom they had at least one episode of unprotected anal sex (insertive or receptive), or men who had unprotected anal sex with a man they knew at the time was HIV+. Non-risk-takers (NRT) were men who reported only regular male sex partners (> once/month) within the last year, men who reported always using condoms during anal sex, and those who did not have anal sex. Logistic regression was used to identify independent predictors of sexual risk-taking among RT and NRT.


As of April/96, data from a total of 287 HIV-negative men (197 NRT and 90 RT) were available. RT were more likely to have unstable housing (p=0.05), less education (p=0.06), a higher CES-D score (p=0.09), and were more likely to use cocaine (40% vs 24%, p=0.007), alcohol (>10 drinks/week, 32% vs 18%, p=0.006), cigarettes 66% vs 52%, p=0.03), and nitrate inhalants (38% vs 27%, p=0.06). RT were also more likely to have been paid for sex in the last year (p=0.08) and to report ever experiencing NCS (41% vs 30%, p=0.06). A significant trend towards higher proportions of RT was observed for more recent episodes of NCS as a youth or adult (c2 trend p=0.02). In the final multivariate model, independent predictors of sexual risk-taking were >10 drinks of alcohol per week (AOR=1.89; CI: 1.05- 3.43), use of cocaine (AOR=1.75; CI: 1.01- 3.04), and NCS over age twelve (AOR=2.22, CI: 1.25-3.95). Results were unchanged adjusting for other factors including age, paid sex or other drug use.


Our results support earlier studies which found that substance use is associated with high-risk sexual behavior among young MSM. However, sexual abuse was independently associated with a two-fold increased risk of sexual risk-taking, which suggests that sexual abuse counseling should be a component of HIV prevention efforts. Further study of the relationship between past sexual abuse, psychologic distress and the ability to negotiate safer sex is urgently required in an effort to reduce the risk of HIV transmission in this vulnerable population.

Steffanie A. Strathdee
B.C. Centre for Excellence in HIV/AIDS
St. Paul's Hospital
#608 - 1081 Burrard Street
Vancouver, B.C. V6Z 1Y6
Tel: (604) 631-5535; Fax: (604) 631-5464
E-mail: steff@hivnet.ubc.ca
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Created: August 2, 1996
Last modified: August 2, 1996

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