Sex Trading and Other HIV Risks among Drug-Involved Men: Differential Associations with Childhood Sexual Abuse

Abstract

This study examined the prevalence of childhood sexual abuse (CSA), sex trading, and other HIV risks among a random sample of 356 men in heterosexual relationships who were enrolled in methadone treatment in New York City. Mediational analyses were performed to test a hypothesis that selected dimensions of substance use history and psychopathology mediate the relationship between CSA and sex trading and HIV risks. Thirty-eight percent (n = 135) of participants reported a history of CSA. CSA history was significantly associated with sex trading (adjusted OR = 2.80, 95% CI [1.67, 4.64]) and HIV risks (adjusted OR = 2.10, 95% CI [1.22, 3.62]). The relationship between CSA and sex trading was partially mediated by substance use and psychopathology. The relationship between CSA and HIV risks was completely mediated by substance use and psychopathology. These findings highlight the need for targeted HIV prevention, mental health services, and substance abuse treatment for drug-involved men with a history of CSA.