Non-consensual sex experienced by men who have sex with men: prevalence and association with mental health

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Abstract

Little is known about the psychosocial factors associated with sexual assault experienced by males. Men (N=358), 19–35 years of age, recruited by community outreach, completed questionnaires. Eligibility criteria included: being HIV-negative and self-identifying as gay or bisexual. Lifetime prevalence rates of childhood sexual abuse, juvenile prostitution, and adult sexual assault were determined. The mental health of this population was explored including associations between sexual victimization and mental health disorders (alcohol abuse, suicidal ideation and attempts, mood disorders, and poor self-esteem). Almost 1 in 10 of the men had engaged in juvenile prostitution, 14% were forced into sexual activity before 14 years of age, and 14% were sexually victimized after the age of 14. Those exposed to non-consensual sex were 2.9 (95% CI: 1.8–4.7) times more likely to abuse alcohol than those free of victimization. Those who reported childhood sexual abuse were 3.3 (95% CI: 1.7–6.4) times more likely to have attempted suicide. Juvenile prostitution was associated with current depression (OR=6.4; 95% CI: 2.8–14.9). Health professionals have the responsibility to respond competently and sensitively to victims of sexual violence. To do this, many need to recognize the prevalence of male sexual trauma, to deconstruct their personal beliefs about same-sex sexual violence, and to learn to ask sensitive questions in their assessment interviews.

Section snippets

Background

There is little empirically known of the lifetime prevalence or consequences of childhood sexual abuse or sexual assault in men. Coxell et al. studied a cross-sectional, convenience sample of about 2500 British men who attended general physicians’ practices [1]. Of these men, 2.9% reported non-consensual sex experienced as adults, 5.4% reported non-consensual sex experienced as children, and 7.7% reported sexual experiences as children that would have been considered criminal acts according to

Methods

The Vanguard Project, started in May 1995, is an ongoing study of HIV rates and risk factors in young men who have sex with men in the Greater Vancouver area of British Columbia, Canada [8], [9], [10], [11], [12]. Men with homosexual and bisexual behavior, aged 19–30 years, recruited through physicians’ offices, walk-in medical clinics, and community outreach, are eligible to participate if they have not previously tested HIV-positive, and if they self-identify as gay or bisexual, or have sex

Personal characteristics

The study participants (N=358) ranged in age from 19 to 35 years (M=28.6; S.D.=3.6). Most (85.2%) had at least a high school education and most (89.3%) were employed. Their annual income, including funds from salaries, the sex trade, and drug trafficking, ranged from less than CAD$ 5000 to more than CAD$ 50,000 (median earned CAD$ 25,000—29,999). Almost all (96.1%) lived in stable housing (i.e. owned or rented) while the remainder lived in hotels, rooming houses, shelters, hostels, or on the

Discussion

The lifetime prevalence of non-consensual sexual assault in this group of men with homosexual and bisexual sexual orientation is considerably higher than that recently reported in a convenience sample of British men and somewhat lower than that reported in American samples of both groups of men [1], [2], [3], [4]. A full 35% of the respondents in this study reported some kind of non-consensual sex, 10% reported involvement in juvenile prostitution, 14% were sexually abused as children, and 14%

References (28)

  • K.J Craib et al.

    Comparison of sexual behaviors, unprotected sex, and substance use between two independent cohorts of gay and bisexual men

    AIDS

    (2000)
  • S.A Strathdee et al.

    Factors associated with willingness to participate in HIV vaccine trials among HIV-negative injection drug users and young gay and bisexual men

    AIDS Behav.

    (2000)
  • J.A Ewing

    Detecting alcoholism: the CAGE questionnaire

    JAMA

    (1984)
  • D.A Fiellin et al.

    Screening for alcohol problems in primary care: a systematic review

    Arch. Intern. Med.

    (2000)
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