Ethnic identity and social support as mediators between childhood sexual abuse and depression among black men who have sex with men

Donte T. Boyd, The Ohio State University, College of Social Work, Columbus, OH, USA; Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA. Electronic address: boyd.465@osu.edu.
Kristian V. Jones, University of Washington, School of Social Work, Seattle, WA, USA.
Camille R. Quinn, University of Michigan, School of Social Work, Ann Arbor, MI, USA.
Mandy Hill, University of Texas, McGovern Medical School, Houston, TX, USA.
LaRon E. Nelson, Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA; Yale School of Nursing, New Haven, CT, USA.
Geetha Beauchamp, Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Lynda Emel, Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Lisa Hightow-Weidman, Florida State University, College of Nursing, Tallahassee, FL, USA.
Steve Shoptaw, University of California Los Angeles, David Geffen School of Medicine, Division of Family Medicine, Los Angeles, California, USA.
Manya Magnus, George Washington University, Milken Institute School of Public Health, Department of Epidemiology, DC, USA.
Estelle Piwowar-Manning, Johns Hopkins University, School of Medicine, Department of Pathology, Baltimore, MD, USA.
Kenneth H. Mayer, Fenway Health, The Fenway Institute, Boston, MA, USA.
Sheldon D. Fields, Pennsylvania State University, Ross and Carl Nese College of Nursing, University Park, PA, USA.
Darrell P. Wheeler, State University of New York, New Paltz, New Paltz, NY, USA.
Typhanye V. Dyer, University of Maryland, Department of Epidemiology and Biostatistics, College Park, MD, USA.
Leo Wilton, State University of New York at Binghamton, Department of Human Development, Binghamton, NY, USA; University of Johannesburg, Department of Humanities, South Africa.

Document Type

Journal Article

Publication Date

9-19-2024

Journal

Child abuse & neglect

Volume

157

DOI

10.1016/j.chiabu.2024.107064

Keywords

Black MSM; Childhood sexual abuse; Depression symptoms; Ethnic identity; Social support

Abstract

BACKGROUND: Survivors of childhood sexual abuse (CSA) often experience long-term adverse mental health effects, a trend that has been observed in research focusing on men who have sex with men (MSM), especially Black MSM. OBJECTIVE: The aim of this study was to investigate the direct and indirect effects of childhood sexual abuse on depression symptoms among Black MSM through early sexual debut, histories of incarceration, ethnic identity, and social support. In addition, we examine the role of social support and ethnic identity as mediators of depression symptoms. PARTICIPANTS AND SETTING: The HPTN 073 study enrolled and followed 226 HIV-uninfected Black MSM in three US cities (Los Angeles; Washington, DC; and Chapel Hill, North Carolina) from February 2013 to September 2015. Study participants were offered once-daily oral emtricitabine/tenofovir preexposure prophylaxis combined with counseling and followed for 52 weeks. METHODS: A path analysis was used to examine direct and indirect effects of CSA experiences on depression symptoms through incarceration, early sexual debut ethnic identity, and social support, and to see whether social support and ethnic identity mediated the relationship between incarceration and depression symptoms. RESULTS: Our results indicate that childhood sexual abuse was direct and positively associated with early sexual debut (β = 0.21, p < .001). Both ethnic identity (β = -0.14, p < .001) and social support (β = -0.82, p < .001) were direct and negatively associated with depressive symptoms. CONCLUSION: Our research underscores the significant impact of CSA factors on the life trajectories of some Black MSM, including experiences such as incarceration, sexual debut, and depression symptoms.

Department

Epidemiology

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