Joseph A. Catania, PhD¹, Jay Paul, PhD², Lance M. Pollack, PhD¹, Jesse A. Canchola, MS³, Y. Jason Chang⁴, Torsten B. Neilands, PhD⁵, and Dennis osmond, PhD¹. (1) Center for AIDS Prevention Studies, University of California San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94143, (415) 597-9161, jcatania@psg.ucsf.edu, (2) Medicine, University of California, San Francisco, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105, (3) Institute for Health and Aging, University Of California, San Francisco, 3333 California Street Suite 340, San Francisco, CA 94118, (4) Center for AIDS Prevention Study, Health Survey Research Unit, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105, (5) Center for AIDS Prevention Studies, University of California, San Francisco, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105

Childhood sexual abuse (CSA) is highly prevalent (20%) among men who have sex with men (MSM) and prior work has shown MSM with a history of CSA vs. those with no CSA history to have significantly higher prevalences of HIV infection and of high risk sexual behavior. The present study, based on a household probability survey of MSM (N = 1078), tested a model designed to test potential mediators of the relationship between CSA and anal intercourse in primary and secondary sexual relationships. Using latent variable modeling we examined how coping (affective, behavioral escape avoidance, cognitive escape avoidance), emotional (anger, depression), sexual (e.g., preoccupation with sex), and interpersonal (e.g., impression management) motivations, sexual scripts (submissive and dominant scripts), interpersonal sexual skills (e.g., sexual assertiveness), and risk appraisal (self/partner) mediate CSA and anal intercourse. The statistical model proved robust and for the most part consistent with the proposed theoretical model for secondary sexual relationships, but a less complex model was observed for primary relationships. The results suggest that the effects of CSA on risk behavior are mediated by a substantial array of factors that challenge current conceptions of HIV prevention programming. The results are discussed within the context of expanding HIV prevention efforts and the challenges of working with men with CSA histories.

Learning Objectives:

• -Recognize importance of developmental trauma on HIV risk of men who have sex with men.
• -Understanding of mediators of childhood sexual abuse and HIV risk for men who have sex with men.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.