200312 A Meta-Analysis of Health Disparities among Gay/Bisexual Men relating to Early Sexual Abuse

Tuesday, November 10, 2009: 4:30 PM

Mark S. Friedman, PhD , Center for Research on Health and Sexual Orientation and Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
Michael P. Marshal, PhD , Center for Research on Health and Sexual Orientation and Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA
Thomas E. Guadamuz, PhD, MHS , Center for Research on Health and Sexual Orientation and Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
Sara Luby, BA , Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA
Helen Smith, MPH , Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
Carolyn F. Wong, Ph D , Community, Health Outcomes, and Intervention Research, Childrens Hospital Los Angeles, Los Angeles, CA
Chongyi Wei, MA , Center for Research on Health and Sexual Orientation and Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
Mackey R. Friedman, MPH , Pennsylvania Prevention Project, University of Pittsburgh, Pittsburgh, PA
Ron Stall, PhD , Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
Background

Gay/bisexual men, compared to heterosexual males, have higher prevalence rates for mental health problems, substance abuse and HIV infection. In the general population, early sexual abuse is associated with these same negative health outcomes. Since gay/bisexual men are more likely to experience early sexual abuse than heterosexual men, health disparities among adult gay/bisexual men may result in part from early childhood sexual abuse. We conducted a meta-analysis to examine the relationship between sexual abuse and health outcomes in gay and bisexual men.

Methods

Journal articles published between 1970 and 2006 that compared rates of early sexual abuse between abused versus non-abuse gay/bisexual men were included. Coding was implemented independently by two individuals. Mixed effects models were tested and sensitivity analyses were performed.

Results

Twenty-seven studies were included that compared abused versus non-abused gay/bisexual men. Compared to non-abused men, abused gay/bisexual men had 61%, 73%, 74%, and 55% greater odds of being HIV+, engaging in HIV sexual risk behavior, experiencing mental health problems, and abusing substances, respectively.

Conclusions

Early sexual abuse puts gay/bisexual men at elevated risk for negative health outcomes. Prevention and treatment interventions are needed to address sexual abuse against gay/bisexual youth. In addition, longitudinal studies are needed to better understand the mechanisms of sexual abuse in relation to health outcomes.

Learning Objectives:
1. Describe the four steps associated with conducting a meta-analysis. 2. Identify the strengths and weaknesses of studies that describe the relationship between early sexual abuse and health outcomes, and formulate a research agenda for future. 3. Compare rates of HIV infection, substance use/abuse, and mental health problems between abused versus non-abused gay/bisexual men.

Keywords: HIV/AIDS, Gay Men

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My primary research interest is the development of health problems and resiliency among gay and bisexual adolescents and health disparities among gay and bisexual men. My research projects to date have focused on defining and measuring adolescent sexual orientation; the relationship between gender-role nonconformity, bullying, and suicidality among gay youth; and childhood and adolescent antecedents of adult health problems among gay males. I was recently awarded a K01 Mentored Research Scientist Development Award to longitudinally study gay male adolescents using the Internet (Ron Stall, Mentor). MOST RECENT PUBLICATIONS Marshal, M.P., Friedman, M.S., Stall, R., King, K.M., Miles, J., Gold, M.A., Bukstein, O.G., & Morse, J.Q. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103(4), 546-556. Stall, R., Friedman, M.S., & Catania, J. (2008). Interacting epidemics and gay menís health: A theory of syndemic production among urban gay men. In R.J. Wolitski, R. Stall & R.O. Valdiserri (Eds.), Unequal opportunities: Health disparities among Gay and Bisexual Men in the United States. New York: Oxford University Press. Friedman, M.S., Koeske, G.F., Silvestre, A.J., Korr, W.S., & Sites, E.W. (2006). The impact of gender-role nonconforming behavior, bullying and social support on suicidality among gay male youth. Journal of Adolescent Health, 38(5), 621-623.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.