Association between childhood physical abuse, unprotected receptive anal intercourse and HIV infection among young men who have sex with men in Vancouver, Canada.

Arn J Schilder,David Moore,Jay Pai,Robert S Hogg,Julio S G Montaner,Aranka Anema,Ashleigh Rich,Cari L Miller,Steffanie A Strathdee,Keith Chan

doi:10.1371/journal.pone.0100501

Abstract

IntroductionThe association between childhood sexual abuse and HIV risk among men who have sex with men (MSM) is well established. However, no studies have examined the potential impact of other forms of childhood maltreatment on HIV incidence in this population.MethodsWe explored the impact of child physical abuse (CPA) on HIV seroconversion in a cohort of gay/bisexual men aged 15 to 30 in Vancouver, Canada. Cox proportional hazard models were used, controlling for confounders.ResultsAmong 287 participants, 211 (73.5%) reported experiencing CPA before the age of 17, and 42 (14.6%) reporting URAI in the past year. After a median of 6.6 years follow-up, 16 (5.8%) participants HIV-seroconverted. In multivariate analysis, CPA was significantly associated with HIV seroconversion (adjusted hazard ratio [AHR] = 4.89, 95% confidence interval (CI): 1.65–14.48), after controlling for potential confounders.ConclusionOur study uncovered a link between childhood physical violence and HIV incidence. Results highlight an urgent need for screening of young gay and bisexual men for histories of violence, and social and structural supports to prevent HIV transmission in this population.

Highlights

The association between childhood sexual abuse and HIV risk among men who have sex with men (MSM) is well established
Recent estimates suggest that MSM account for 61% of new HIV infections in the United States (US) [2]; 45% of new infections in Canada [3] and 43% of HIV infections in the World Health Organization (WHO) European region [4]
Similar findings have been observed in other populations including a random sample of youths seen consecutively at public health clinics in 10 US cities [22], a population-based study of adults who participated in a telephone survey in Washington State [23], and women participating in the Women’s Interagency HIV Study (WIHS) collaborative project [24]

Summary

Introduction

The association between childhood sexual abuse and HIV risk among men who have sex with men (MSM) is well established. Bisexuals, and heterosexuals reporting same-sex sexual partners have increased odds of having experienced childhood maltreatment [10] Studies examining this relationship among gay and bisexual men have tended to focus on the role of childhood sexual abuse (CSA), and have uncovered strong associations between CSA and unprotected anal intercourse [11,12,13,14,15,16], transactional sex [11,14], frequent casual sex [13,14,17,18,19,20] and HIV-positive serostatus [11,13,14, 15,17,21]. Similar findings have been observed in other populations including a random sample of youths seen consecutively at public health clinics in 10 US cities [22], a population-based study of adults who participated in a telephone survey in Washington State [23], and women participating in the Women’s Interagency HIV Study (WIHS) collaborative project [24]

Methods

Results

Discussion

Conclusion