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Gay Men with a History of Childhood Abuse and Victimization More Likely to Engage in Drug Abuse, Risky Behavior

A new study by the University of Pittsburgh’s Graduate School of Public Health has found that gay men who experienced childhood abuse—including sexual abuse and social shaming—are more likely to have psychosocial problems during adulthood, which also puts them at a higher risk of drug abuse and HIV infection.

For the longest-running study on HIV/AIDS to be funded by the National Institutes of Health, researchers investigated trends among 1,086 gay and bisexual men enrolled in the Multicenter AIDS Cohort Study (MACS) who were both HIV positive and negative beginning in 1983. The purpose of the study was to examine the prevalence of “syndemic” conditions, or the co-existence of two or more health conditions that are synergistically related (“synergistic epidemics”) and thereby increase the pervasiveness of disease within a population.

Lead author Sin How Lim, Ph.D, and a team of researchers found that about 10% of the participants had a history of childhood abuse and 30% had experienced victimization between the ages of 12 and 14 regarding their sexuality, including verbal assaults, bullying, threats of physical violence, and actual physical assaults. The researchers discovered that men who had experienced childhood sexual abuse or felt a sense of “masculinity failure” were more susceptible to substance abuse, depression, domestic violence, and risky sexual behavior in adulthood, all of which attribute to their likelihood of contracting HIV. As a result, the researchers concluded, this subgroup of men is at greater risk of syndemic conditions.

In a sub-study, researchers examined the prevalence of substance abuse among 1,378 older gay and bisexual men enrolled in the MACS database who were both HIV positive and negative. The participants were between the ages of 44 to 63, and were measured on their level of recreational drug use involving methamphetamine, cocaine, ecstasy, and poppers over a ten-year period (from 1998 to 2008).

Researchers discovered that most gay/bisexual men (79%) used illicit substances infrequently during the ten-year period, but that three other distinct subgroups emerged. About 6% of participants were found to engage in consistently high levels of substance abuse; 7% of participants had decreased their level of substance abuse overtime; and more than 7% had increased their level of substance abuse overtime. Substance abuse by gay men is known to increase their chances of engaging in risky behavior, experiencing multiple health problems, and contracting HIV infection. Although the majority of participants did not engage in frequent substance abuse, the three subgroups had all maintained high levels of recreational drug use over a ten-year period.

Traumatic events experienced by gay men in early childhood were directly linked to their risk of having syndemic psychosocial conditions as adults. Not only were such events as sexual assault, physical assault, and social isolation detrimental to the development of these men during childhood, but it also stigmatized them from receiving proper treatment and increased their likelihood of accruing further psychosocial disorders. Because these negative socializations were not met with early intervention methods, they caused multiple chronic conditions that now impact the men in adulthood.

The researchers presented their data at the XVIII International AIDS Conference in Vienna on Wednesday, concluding that more effective, interrelated intervention strategies that approach the identified risk factors simultaneously rather than individually must be established in order to circumvent the occurrence of lifelong mental illness, risky behavior, and spread of HIV/AIDS among this vulnerable group of individuals.

Sources: Health Day, Risky Behavior, Drug Use Among Some Gay Men Linked to Childhood Abuse, July 21, 2010

Science Blog, Most men in long-term study of HIV report low use of illicit drugs, July 21, 2010

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