Purpose: Childhood sexual abuse (CSA) is a traumatic experience that has been shown to be associated with risks later in life, including mental illness, HIV/STD risk, intimate partner violence, and substance abuse. This paper describes the prevalence and frequency of CSA as well as its association with the adult sexual risk behaviors among a festival-based sample of men who have sex with men (MSM). Previous research has used convenience samples linked to high risk venues (bars, HIV/STI clinics) and has rarely analyzed CSA frequency and is, therefore, unlikely to have produced findings that are typical for the broader MSM community.

Methods: Participants for the study were recruited over two years from the Twin Cities' (MN) GLBT Pride Festival by trained volunteers who utilized random numbers tables for selection of potential participants in the crowd. Participants were required to be at least 18 years of age, male, and a resident of the upper mid-west region. Participants were asked to complete an anonymous questionnaire that included demographics, sexual behaviors (including anal/oral, insertive/receptive sex) HIV/STI infection history, HIV risk factors (including drug and alcohol use, exchanging sex for payment) as well as the occurrence and frequency of CSA (“As a child or adolescent, were you ever forced to have unwanted sexual activity with adults?” “If yes, was it once, sometimes or regularly?”). Participants were given the opportunity to fill out the survey in a private tent on the fairgrounds.

Results: A total of 891 men were included in the analysis. The sample available for analysis was mature (median age = 34), mostly identified as gay (95.3%), mostly white (88.8%), well-educated (61.5% had a college degree) and highly/moderately acculturated to the LGBT community (96.4%). Nine percent of the men were HIV-positive. A history of CSA was reported by 163 men (18.3%). Of those who reported CSA, 53% reported sexual abuse occurring once, 26.1% sometimes/occasionally, and 20.9% regularly. Multivariate logistic regression analysis revealed that compared to men who reported no CSA, those who were regularly abused were 2.8 times more likely to be HIV-positive (95% CI 1.05, 7.62; p = 0.04), 7.9 times more likely to ever have exchanged sex for some form of payment (95% CI 3.28, 19.17, p < 0.0001), and 6.4 times more likely to be a current user of sex drugs (95% CI 2.15, 18.78, p < 0.001). While not statistically significant, men who were regularly abused were almost twice as likely to report that they engaged in unsafe sex in the 60 days prior to the interview as men who were never abused.

Implications for Practice: The findings indicate a high prevalence of CSA among this population and are cause for concern. Men who report regular occurrence of CSA have greatly increased risks for HIV infection and engagement in high risk behaviors. Social workers will need to be more vigilant to screen for CSA frequency and to provide enhanced prevention programs, as well as targeted interventions that address the impact of frequent CSA upon risk taking behavior.