ABSTRACT

Childhood sexual abuse (CSA) is associated with a wide range of health outcomes and is more prevalent among men who have sex with men (MSM) compared to men who have sex with women exclusively and among transgender women (TW) compared to cisgender peers; however, there is a lack of consensus regarding an explanatory theoretical model. This analysis examined these models across health outcomes using baseline data from a longitudinal study of MSM and TW in Chicago (n = 1,035) collected from 2015 to 2019. Severity of CSA was measured for two age ranges (prior to 13 and 13–17). Logistic regression and negative binomial regressions were estimated. Teenage experiences of CSA were associated with alcohol problems, cannabis problems, suicide ideation/attempt, depression, condomless anal sex partners, rectal STI, and HIV. Pre-teenage CSA was associated with alcohol use and depressive symptoms. Significant interactions across age of experience of CSA were found for alcohol problems, cannabis problems, and condomless anal sex partners. Consistent with previous literature, this analysis found CSA to be a significant influence on various health outcomes. No single explanatory framework emerged; however, adolescent exposures may be more closely linked to health outcomes and risk behaviors than pre-teenage or cumulative exposures.

摘要

儿童期性虐待 (CSA) 与广泛的健康结果有关，与仅与女性发生性关系的男性相比，在男男性行为者 (MSM) 中更普遍，在跨性别女性 (TW) 中与顺性别同龄人相比更为普遍；然而，关于解释性理论模型缺乏共识。该分析使用 2015 年至 2019 年收集的芝加哥 MSM 和 TW 纵向研究（n = 1,035）的基线数据检查了这些模型的健康结果。CSA 的严重程度测量了两个年龄范围（13 岁之前和 13-17 岁） . 估计逻辑回归和负二项式回归。CSA 的青少年经历与酒精问题、大麻问题、自杀意念/企图、抑郁、无安全套肛交、直肠性传播感染和 HIV 相关。青春期前的 CSA 与饮酒和抑郁症状有关。在酗酒问题、大麻问题和无安全套肛交伴侣方面，发现跨年龄的 CSA 经验存在显着的相互作用。与以前的文献一致，该分析发现 CSA 对各种健康结果有重大影响。没有出现单一的解释框架；然而，与青春期前或累积暴露相比，青少年暴露与健康结果和风险行为的关系可能更为密切。