Men's self-definitions of abusive childhood sexual experiences, and potentially related risky behavioral and psychiatric outcomes.
OBJECTIVE
To estimate how many heterosexual and gay/bisexual men self-define abusive childhood sexual experiences (CSEs) to be childhood sexual abuse (CSA) and to assess whether CSA self-definition is associated with risky behavioral and psychiatric outcomes in adulthood.


METHODS
In Philadelphia County, 197 (66%) of 298 recruited men participated in a telephone survey. They were screened for CSEs and then asked if they self-defined abusive CSEs to be CSA; they also were asked about risk behavior histories and post-traumatic stress disorder (PTSD) and depression symptoms.


RESULTS
Of 43 (22%) participants with abusive CSEs, 35% did not and 65% did self-define abusive CSEs to be CSA ("Non-Definers" and "Definers," respectively). Heterosexual and gay/bisexual subgroups' CSA self-definition rates did not significantly differ. When self-definition subgroups were compared to those without CSEs ("No-CSEs"), Non-Definers had lower perceived parental care (p=.007) and fewer siblings (p=.03), Definers had more Hispanics and fewer African Americans (p=.04), and No-CSEs had fewer gay/bisexual men (p=.002) and fewer reports of physical abuse histories (p=.02) than comparison groups. Non-Definers reported more sex under the influence (p=.001) and a higher mean number of all lifetime sex partners (p=.004) as well as (only) female sex partners (p=.05). More Non-Definers than Definers reported having experienced penetrative sex as part of their CSA (83% vs. 35%, p=.006). Different explanations about self-definition were provided by subgroups.


CONCLUSIONS
Many men with abusive CSEs do not self-define these CSEs to be CSA, though not in a way that differs by sexual identity. The process by which men self-define their abusive CSEs to be CSA or not appears to be associated not only with self-explanations that differ by self-definition subgroup, but also with behavioral outcomes that impart risk to Non-Definers.
Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, University of Pennsylvania School of Medicine, Philadelphia, PA, United States.
William C
WC
Holmes
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D003717:Denial, Psychological; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology / Q000635:transmission; D006306:Health Surveys; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015143:Philadelphia; D012747:Sexual Partners / Q000523:psychology; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D047568:Unsafe Sex; D014505:Urban Population