Disclosure of childhood sexual abuse histories by MSM: Identifying venues for HIV prevention

Background. Childhood sexual abuse (CSA) is prevalent (20%) among men who have sex with men (MSM) and contributes to HIV-risk. We examined disclosure of CSA histories. Disclosure is a first-step towards seeking professional help and disclosure recipients provide avenues for targeting HIV-prevention. Methods. Data were obtained from an urban-household sample of MSM (N = 334 CSA victims), and a national survey of heterosexuals (N = 542 victims). Results. Thirteen-percent of MSM reported non-disclosure of CSA histories. Approximately 58% reported disclosure to health practitioners (medical/mental health); few disclosed on Internet chat rooms (5%) or to non-health professionals (19%). Informal social networks are highly disclosed to (83%). Logistic regression models showed that age and race/ethnicity, but not social class, were significant correlates of disclosure. Older victims were more likely to be non-disclosers in general (OR = 2.94, p = .002), and less likely to disclose to health professionals (OR = 3.23, p = .001). Ethnic minority victims were more disclosing in general (OR = 2.39, p = .05), but less likely to disclose to health professionals (OR = .42, p = .002). Compared to MSM, heterosexuals are more non-disclosing (64%) and less likely to disclose to health professionals (25%). Conclusions. MSM victims are more disclosing to health professionals, who may be conduits for HIV prevention efforts. However, older and ethnic minority victims may best be reached through informal network strategies. The findings will be discussed in terms of programs geared towards facilitating disclosure, and tailoring of HIV prevention messages to CSA victims.