Precursors to maladaptive adult functioning: An internet assessment of Men who have Sex with Men.

This study explored the association between childhood sexual abuse, posttraumatic stress disorder (PTSD) and adult functioning in a risky sample of Men who have sex with men (MSM). Four hundred eighty-five men participated in The Men’s Health Survey, an online survey assessing MSM Health, stressful life events, sex, and coping. MSM were recruited from social media venues and internet message boards marketed toward men looking for sexual encounters in San Francisco, Los Angeles, Miami, New York, Chicago, Washington D. C., and Atlanta. Twenty nine percent of the sample (n = 140) reported non-consensual sexual activity before the age of 16. Twenty-eight percent (n = 148) of the total sample screened positive for symptoms of PTSD. PTSD scores varied significantly by participants’ HIV status: 61% (n = 50) of HIV positive men screened positive for PTSD, versus 17% (n = 54) of HIV negative men and 38% (n = 34) of men with an unknown status. Ninety percent of HIV positive MSM with a history of Childhood sexual abuse screened positive for PTSD. Having a history of both childhood sexual abuse and PTSD predicted a fear of intimacy, poorer health outcomes, and drug abuse. Neither PTSD nor childhood sexual abuse were associated with sexual risk. Empirical models organizing these relationships were tested via structural equation modeling. PTSD mediated the relationship between childhood sexual abuse and fear of intimacy and poorer health outcome.