The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women

ABSTRACT

This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.

KEYWORDS:

• Childhood sexual abuse
• mental health
• sex motives
• sexual risk
• HIV

Acknowledgments

Funding (R37AA025212) was provided by the National Institute on Alcohol Abuse and Alcoholism to the fourth author (K.C. Davis). Funding (R01AA017608) to support data collection was provided by the National Institute on Alcohol Abuse and Alcoholism to the fourth author (K. C. Davis). The first author (E. C. Neilson) was supported by funding from the National Institute of General Medical Sciences while analyzing data and writing the manuscript (#8P20GM103436).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation at the University of Washington and the National Institutes of Health and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients to be included in the study.

Additional information

Funding

(R37AA025212) was provided by the National Institute on Alcohol Abuse and Alcoholism to the fourth author (K.C. Davis). Funding (R01AA017608) to support data collection was provided by the National Institute on Alcohol Abuse and Alcoholism to the fourth author (K. C. Davis). The first author (E. C. Neilson) was supported by funding from the National Institute of General Medical Sciences while analyzing data and writing the manuscript (#8P20GM103436).

Notes on contributors

Elizabeth C. Neilson

Elizabeth C. Neilson, MSW, MPH, PhD, is an Assistant Professor in the Department of Psychology at Eastern Michigan University in Ypsilanti, Michigan and Director of the EMU Community Behavioral Health Clinic.

Trevor J. Schraufnagel

Trevor J. Schraufnagel is a Clinical Psychology in private practice in Santa Monica, California, a Clinical Assistant Professor (VCF) in the Department of Psychiatry & Biobehavioral Sciences at the UCLA Semel Institute for Neuroscience and Human Behavior, and an Assistant Clinical Professor in the Department of Psychology at the University of California, Los Angeles.

William H George

William H George, PhD is a Professor in the Department of Psychology at the University of Washington in Seattle, Washington.

Kelly Cue Davis

Kelly Cue Davis, PhD is an Associate Professor in the Edson College of Nursing and Health Innovation at Arizona State University in Phoenix, Arizona.