Posttraumatic Stress Symptoms and HIV Risk-Related Behaviors among Young Sexual and Gender Minorities Assigned Male at Birth: the Moderating Effects of Teenage Childhood Sexual Abuse.

Young sexual and gender minorities assigned male at birth (SGM-AMAB) experience significant sexual health disparities. Teenage childhood sexual abuse (CSA) may have lasting effects on adulthood trauma response, including engagement in HIV-related risk behaviors (HRB). This study examined the moderating effects of teenage CSA on the longitudinal associations between posttraumatic symptom clusters and HRB among young SGM-AMAB. The analytic sample comprised SGM-AMAB (N = 487) living in the Chicago metropolitan area, aged 17-32 (M = 24.78) enrolled in the RADAR longitudinal cohort study. Structural equation models (SEM) using Bayes estimation with 10,000 iterations were estimated to examine the moderating effects of any CSA exposure and severity indices (e.g., touching, penetration) on the associations between posttraumatic symptom clusters at Time 1 (T1) and HRB at Time 2 (T2) 6-month follow-up. Model fit was acceptable, χ2 (df = 164) = 450.15, p <.001, RMSEA = 0.06, SRMR = 0.04, CFI = 0.93, TLI = 0.92. Avoidance at T1 predicted fewer condomless sex partners at T2 across CSA models. We observed 15 interaction effects across CSA models and outcomes. The moderating effects of both any CSA (β = 0.20, 95% CI = 0.02 - 0.38) and penetration CSA (β = 0.34, 95% CI = 0.14 - 0.55) changed the direction of the direct effect of avoidance on condomless sex partners, such that avoidance symptoms predicted more condomless sex partners among those with these CSA histories. This study observed patterns of association by posttraumatic symptom cluster, CSA index, and HRB outcome. Future directions and clinical implications are discussed.