سوء استفاده جنسی دوران کودکی در مردان و رفتارهای جنسی پرخطر پس از آن: مسیر بالقوه استفاده از الکل

Objective Childhood sexual abuse (CSA) among boys has been associated with a variety of subsequent maladaptive behaviors. This study explored a potential connection between CSA and an increased likelihood of risky sexual behavior in adulthood. Further, the study examined whether or not alcohol use may contribute to this relationship. Method As part of a study on alcohol and sexual decision-making, 280 heterosexual men completed multiple background questionnaires pertaining to past and current sexual experiences and patterns of alcohol use. CSA history was obtained and severity ratings were made based on type of contact reported. Results CSA was reported by 56 men (20%). Structural equation modeling revealed that CSA positively predicted number of sexual partners directly as well as indirectly, through its effect on alcohol use. Specifically, greater CSA severity predicted significantly lower age of first intoxication, which in turn predicted greater current alcohol consumption, followed by greater use of alcohol before sexual intercourse, leading to an increased number of reported sexual partners. The reported frequency of condom use was not predicted by CSA severity or the alcohol-use pathway. Conclusions These findings suggest that CSA influences risky sexual behavior via multiple pathways and that more severe CSA may lead to elevated sexual risk indices. Moreover, these results suggest that men may elevate their risk of sexually transmitted infections via high numbers of sexual partners versus irregular condom use. Practical implications These results highlight the need for adequate assessment and early interventions in order to mitigate the effects CSA may have on subsequent alcohol use and risky sexual behavior. Secondly, ensuring that male CSA victims understand the inherent risks of high numbers of sexual partners may be an effective strategy to interrupt the path toward risk-taking.

Childhood sexual abuse (CSA) among males is not uncommon. Until recently, accurate prevalence rates have remained elusive—apparently because rates of abuse among boys have been masked by particularly low rates of abuse disclosure. Current estimates are that roughly 14% of males are sexually abused during childhood (Briere & Elliott, 2003). Unfortunately, this percentage may also be an underestimate due to continued low rates of disclosure. While less robust than the research literature using female samples, there is ample evidence that male CSA is associated with a broad spectrum of detrimental sequelae (Holmes and Slap, 1998 and Romano and De Luca, 2001). Increased alcohol consumption and elevated rates of sexual risk-taking have both been observed among various populations of male survivors of CSA (DiIorio et al., 2002, Hamburger et al., 2008 and Paul et al., 2001). Additionally, increased alcohol consumption has independently and convincingly been associated with increased risky sexual decision-making (Cooper, 2002 and George and Stoner, 2000). These two lines of independent but intersecting research findings—that CSA is associated with alcohol use and sexual risk-taking and that alcohol use is related to sexual risk-taking—suggest that alcohol is an important component in the path between CSA and subsequent sexual risk-taking. Using survey methodology, the current study investigated these possible linkages among CSA, alcohol use, and sexual risk-taking in a sample of adult heterosexual men from the community.