Between 1-in-6 and 1-in-14 men report histories of child sexual abuse (CSA). CSA rates in men from high HIV risk behavior groups are higher. Studies of the relationship between CSA histories and HIV risk behavior in men, however, are hampered by use of disparate, usually-clinical samples, divergent in the way they were sampled, when they were sampled (i.e., at different times during the shifting trends of HIV risk behavior), and from where they were sampled. Differing investigator-mandated CSA definitions also create interpretation difficulties. Using data from these sources, then, challenge efforts to create interventions to reduce HIV risk in men with past CSA. Random digit dialing (RDD) methodology offers an approach to studying CSA histories in a non-clinical sample of men, providing a relative snapshot of different HIV risk subpopulations simultaneously, thereby limiting the confounding of temporal trends in risk behavior. In addition, comparison subgroups of men without CSA histories can be recruited from the same underlying population. Thus, the independent contribution of a CSA history to HIV risk behavior activity can be studied in a more robust manner, allowing comparisons across different risk groups, while concomitantly exploring other effects such as how abuse self-definition differences affect findings. Some are concerned about feasibility of RDD use in urban sectors with large numbers of individuals engaged in high HIV risk behavior, where no specific RDD evaluation has been done. We propose a feasibility protocol: study one is a cross-sectional study of adult men recruited from high AIDS incidence areas in Philadelphia (PA); study two is a series of follow-up, in-person interviews with men from study one. In study one, 200 men will be recruited via RDD. Study participation rates will be obtained to determine whether similar methods can be used in future, large-scale studies. Injection drug use (IDU) rates will be obtained to determine whether participation rates by men with IDU histories allow study of this risk behavior. Sexual risk behavior rates also will be estimated, as will estimates of the association between CSA histories and sexual risk behavior. In study two, twenty and ten men with and without CSA histories, respectively, will be recruited. In-person interviews will focus on qualitative explorations of how men link an enumeration of their sexual histories with study one reports about CSA histories, as well as how they identify the salience of CSA as a factor in the presence or absence of their risk behavior.
| Holmes, William C (2008) Men's self-definitions of abusive childhood sexual experiences, and potentially related risky behavioral and psychiatric outcomes. Child Abuse Negl 32:83-97 |
| Holmes, William C (2007) Men's childhood sexual abuse histories by one-parent versus two-parent status of childhood home. J Epidemiol Community Health 61:319-25 |
| Holmes, William C; Foa, Edna B; Sammel, Mary D (2005) Men's pathways to risky sexual behavior: role of co-occurring childhood sexual abuse, posttraumatic stress disorder, and depression histories. J Urban Health 82:i89-99 |
| Holmes, William C; Sammel, Mary D (2005) Brief communication: physical abuse of boys and possible associations with poor adult outcomes. Ann Intern Med 143:581-6 |
