Hugh Klein1, David Tilley2. 1. Kensington Research Institute, Silver Spring, Maryland USA and Prevention Sciences Research Center, Morgan State University, Baltimore, Maryland USA. 2. Department of Community and Family Health, University of South Florida, Tampa, Florida USA.
Abstract
PURPOSE: Using a Syndemics Theory conceptual model, this study examines the relationship between childhood maltreatment experiences and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. One of the main advantages to using this theoretical model is that it considers the co-varying influences of factors such as childhood maltreatment, psychological/psychosocial functioning, risk-related preferences, demographic characteristics, substance use/abuse, and attitudes toward risk taking on actual risk practices. METHODS: The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. RESULTS: Childhood maltreatment experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Childhood maltreatment, particularly in the form of emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. CONCLUSIONS: Childhood maltreatment experiences are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, childhood maltreatment appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes.
PURPOSE: Using a Syndemics Theory conceptual model, this study examines the relationship between childhood maltreatment experiences and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. One of the main advantages to using this theoretical model is that it considers the co-varying influences of factors such as childhood maltreatment, psychological/psychosocial functioning, risk-related preferences, demographic characteristics, substance use/abuse, and attitudes toward risk taking on actual risk practices. METHODS: The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. RESULTS: Childhood maltreatment experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Childhood maltreatment, particularly in the form of emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. CONCLUSIONS: Childhood maltreatment experiences are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, childhood maltreatment appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes.
Entities:
Keywords:
HIV risk; childhood maltreatment; men who have sex with men (MSM)
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