Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood

Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.     

Child Sexual Abuse and Negative Affect as Shared Risk Factors for Sexual Aggression and Sexual HIV Risk Behavior in Heterosexual Men

Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ ²[1300] = 2121.79, p < .001; CFI = 0.905; RMSEA [90% CI] = .044 [.041–.047]). Sexual aggression appears to be part of a constellation of sexual risk behaviors; thus, it may be possible to develop prevention programs that target both sexual HIV risk and sexual aggression. CSA is a shared risk factor for sexual aggression and HIV risk behavior through the pathway of anxiety. Thus, anxiety might be one promising target for intervention.     

Physical and sexual violence,childhood sexual abuse and HIV/STI risk behaviour among alcohol-using women engaged in sex work in Mongolia

Although the prevalence of human immunodeficiency virus (HIV) in Mongolia is low, it could increase without strategic prevention strategies. Female sex workers (FSWs) often experience barriers to prevention, including interpersonal violence. This study investigated if childhood sexual abuse (CSA) or recent physical or sexual violence was associated with HIV sexual risk behaviours and if CSA modified associations between recent violence and HIV sexual risk behaviours. Two-hundred twenty-two women who (1) were at least 18 years old and clients at the National AIDS Foundation; (2) reported vaginal or anal sex in the past 90 days in exchange for money or goods and (3) met criteria for harmful alcohol use in the past year were enrolled. In-person interviews assessed sexual risk behaviours and violence in childhood and adulthood. Negative binomial regression, ordinary least squares regression and modified Poisson regression were performed. Sexual risk with paying partners was associated with penetrative CSA and sexual violence by paying partners. CSA and recent violence were not associated with sexual risk behaviours with intimate partners. CSA modified the association between recent sexual violence and unprotected sex with intimate partners. Findings highlight the need for integrated violence and sexual risk reduction services to ensure safe and effective prevention for FSWs.     

Long-term consequences of childhood sexual abuse by gender of victim

BACKGROUND: Childhood sexual abuse (CSA) is a worldwide problem. Although most studies on the long-term consequences of CSA have focused on women, sexual abuse of both boys and girls is common. Thus, a comparison of the long-term effects of CSA by gender of the victim will provide perspective on the need for future research, prevention activities, and treatment of survivors. METHODS: A retrospective cohort study was conducted from 1995 to 1997 among 17,337 adult HMO members in San Diego, California. Participants completed a survey about abuse or household dysfunction during childhood, and multiple other health-related issues. Multivariate logistic regression was used to examine the relationships between severity of CSA (intercourse vs no intercourse) and long-term health and social problems (substance use and abuse, mental illness, and current problems with marriage and family) by gender of victim. Models controlled for exposure to other forms of adverse childhood experiences that co-occur with CSA. Among men, the relationship between the gender of the CSA perpetrator to the outcomes was also examined. RESULTS: Contact CSA was reported by 16% of males and 25% of females. Men reported female perpetration of CSA nearly 40% of the time, and women reported female perpetration of CSA 6% of the time. CSA significantly increased the risk of the outcomes. The magnitude of the increase was similar for men and women. For example, compared to reporting no sexual abuse, a history of suicide attempt was more than twice as likely among both men and women who experienced CSA (p<0.05). Compared with those who did not report CSA, men and women exposed to CSA were at a 40% increased risk of marrying an alcoholic, and a 40% to 50% increased risk of reporting current problems with their marriage (p<0.05). CONCLUSIONS: In this cohort of adult HMO members, experiencing CSA was common among both men and women. The long-term impact of CSA on multiple health and social problems was similar for both men and women. These findings strongly indicate that boys and girls are vulnerable to this form of childhood maltreatment; the similarity in the likelihood for multiple behavioral, mental, and social outcomes among men and women suggests the need to identify and treat all adults affected by CSA.     

Awareness of child sexual abuse prevention education among parents of Grade 3 elementary school pupils in Fuxin City, China

Several recent studies on child sexual abuse (CSA) in Chinese society have shown that the problem is not uncommon, and is associated with poor mental health and health-related risk behaviors of abused youth. It is very important to understand and improve public awareness of CSA prevention, especially for the parents. However, there are few published reports on the problem of parents' awareness. To fill this gap, knowledge, attitudes and practice of CSA prevention education were explored in 385 parents of Grade 3 pupils from four schools in Fuxin City of Liaoning Province in the northeast part of China by self-administered anonymous questionnaires. Among this sample, more than 80% of parents approved of school CSA prevention education. However, at the same time, 47.3% of parents expressed some concern that this education may induce the children to learn too much about 'sex'. Overall, about 60% of parents had told their children that their 'private parts' should not be touched by others and discussed strategies of 'Say "No!", Leave and Tell' in dealing with CSA situations or the situations that may lead to CSA. Only 4.2% of parents had provided books or other material about CSA prevention for their children. The parents' CSA prevention knowledge was inadequate. The findings from this research will be useful in developing CSA prevention education programs in schools and communities, designed to improve parents' knowledge and practice of CSA prevention.     

环孢素A血药浓度监测相关实验室检测研究进展

环孢素A(cyclosporine A, CSA)属于多肽类的免疫抑制剂,广泛用于器官移植和组织移植,具有很好的免疫抑制活性。因其口服吸收差,体内代谢个体差异大,其浓度与疗效和毒性相关,且治疗窗窄,故需对CSA进行血药浓度监测。同时,CSA在体内的代谢产物较多,并且体外实验证明,其代谢产物又各具有不同的活性。市面上CSA血药浓度检测方法较多,原理各不相同,对不同检测方法的选择成为临床及实验室的一大难题。本文针对目前CSA血药浓度检测方法进行综述,并对引起CSA血药浓度差异的药物代谢基因进行说明,望对临床及实验室关于CSA血药浓度的解读有所帮助。     

家长对儿童性虐待的认识及与子女交流状况调查

目的了解幼儿园儿童的家长预防儿童性虐待知识、态度以及与子女交流情况,为在幼儿园和社区中开展预防儿童性虐待教育提供依据.方法用自填式问卷,在某幼儿园以班级为单位整群抽取2个大班的57名儿童家长就儿童性虐待问题的认识及与孩子交流情况进行不记名调查.结果在被调查的家长中,91.1%的家长赞成学校开展预防儿童性虐待教育,40.4%的家长担心这种教育可能会导致儿童对"性"知道得太多.50%的家长与孩子谈论过人体的隐私部位不能随便被人看或触摸,如果有人要看或触摸要坚决说"不",并迅速离开.只有1.8%的家长给孩子看过有关预防儿童性虐待的书刊或音像制品.结论应重视对幼儿园儿童的家长普及预防儿童性虐待知识;重视幼儿园预防儿童性虐待教育的研究,尽快出版相关书籍和音像制品.     

The Effect of Pre-Existing Affect on the Sexual Responses of Women With and Without a History of Childhood Sexual Abuse

Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA.     

医学生对儿童性侵犯认识的定性研究

目的了解医学生对儿童性侵犯的认识,为预防儿童性侵犯教育提供依据.方法采用个人深入访谈的方法对21名在校医学生进行访谈.结果绝大多数被访者听说过儿童性侵犯案例.被访者在以往的学校学习中都没有接受过正式的预防儿童性侵犯教育,对儿童性侵犯问题的了解主要来自书本、杂志和互联网.多数被访者认为预防儿童性侵犯的主要措施是对学生进行教育.绝大多数被访者对性侵犯受害儿童表示同情,并认为不应该歧视受害儿童,应多给予关怀与帮助.结论医学生对儿童性侵犯有一定的认识,但对一些问题的认识仍较片面.     

Acquisition of antibodies to variant antigens on the surface of Plasmodium falciparum-infected erythrocytes during pregnancy

Pregnancy-associated malaria is characterized by Plasmodium falciparum adherence to chondroitin sulfate A (CSA) in placenta, through a particular variant surface antigen (VSA). VSA(CSA)-specific IgG are involved in protection against placental malaria. In order to assess the relationship between VSA(CSA)-specific antibody responses and parity as well as protection against placental malaria, the occurrence of P. falciparum infection was assessed in 306 pregnant women from a low malaria transmission area of Senegal. Anti-VSA(CSA) antibodies against three placental parasite isolates were measured by flow cytometry, at enrollment and delivery. Placental infection prevalence rates were highest in primigravidae, but no clear decreasing trend was observed from the second pregnancy onwards. Anti-VSA(CSA) antibody prevalence rates increased with parity. Both anti-VSA(CSA) antibody prevalence rates and levels increased during pregnancy only in women infected with P. falciparum. Although a single or a very limited number of P. falciparum infections were able to induce an anti-VSA(CSA) antibody response, the level or the quality of this response did not appear to confer protection against placental malaria infection.     

广州市男男性行为者儿童期性虐待经历对成年后高危性行为的影响

  目的  了解广州市男男性行为者（men who have sex with men,MSM）的儿童期性虐待（childhood sexual abuse,CSA）情况,分析CSA对成年后高危性行为的影响。  方法  采用非概率抽样方法招募广州市≥ 18周岁的MSM,通过电子问卷收集调查对象的社会人口学资料、CSA经历和近6个月高危性行为情况。采用χ2检验比较不同社会人口学特征的MSM的CSA经历和近6个月的高危性行为情况,用Logistic回归分析模型分析探讨CSA对高危性行为的影响。  结果  调查对象的平均年龄为（28.35±6.83）岁。26.95%（263/976）的MSM遭受过CSA,近6个月多性伴（multiple sexual partners,MSP）率和无保护肛交（unprotected anal intercourse,UAI）率分别为61.68%（602/976）和47.95%（468/976）。调整了年龄、民族、户籍、本地居住时间、婚姻状况、文化程度、工作状况、个人月收入和性取向之后,有CSA者近6个月发生MSP的风险高于无CSA者（aOR=1.62,95% CI:1.19~2.22）,但近6个月UAI与CSA关联的差异无统计学意义。  结论  广州市MSM经历CSA的比例较高,CSA可增加成年后的高危性行为的风险,因此,制定MSM高危性行为干预措施可能需要考虑CSA的影响。     

Novel adenovirus encoded virus-like particles displaying the placental malaria associated VAR2CSA antigen

The malaria parasite Plasmodium falciparum presents antigens on the infected erythrocyte surface that bind human receptors expressed on the vascular endothelium. The VAR2CSA mediated binding to a distinct chondroitin sulphate A (CSA) is a crucial step in the pathophysiology of placental malaria and the CSA binding region of VAR2CSA has been identified as a promising vaccine target against placental malaria.Here we designed adenovirus encoded virus-like particles (VLP) by co-encoding Simian Immunodeficiency Virus (SIV) gag and VAR2CSA. The VAR2CSA antigen was fused to the transmembrane (TM) and cytoplasmic tail (CT) domains of either the envelope protein of mouse mammary tumour virus (MMTV) or the hemagglutinin (HA) of influenza A. For a non-VLP incorporation control, a third design was made where VAR2CSA was expressed without TM-CT domains.In the primary immunogenicity study in Balb/c mice, VAR2CSA fused to HA TM-CT was significantly superior in inducing ID1-ID2a specific antibodies after the first immunization. A sequential study was performed to include a comparison to the soluble VAR2CSA protein vaccine, which has entered a phase I clinical trial (NCT02647489). The results revealed the induction of higher antibody responses and increased inhibition of parasite binding to CSA using either VAR2CSA HA TM-CT or VAR2CSA MMTV TM-CT as priming vaccines for protein double-boost immunizations, compared to protein prime-double boost regimen. Analysis of pooled serum samples on peptide arrays revealed a unique targeting of several epitopes in mice that had been primed with VAR2CSA HA TM-CT. Consequently, modification of VLP anchors is an important point of optimization in virus-encoded retroviral VLP-based vaccines, and adenovirus VLPs boosted by recombinant proteins offer hope of increasing the levels of protective VAR2CSA specific antibodies.     

Relation of Childhood Sexual Abuse,Intimate Partner Violence,and Depression to Risk Factors for HIV Among Black Men Who Have Sex With Men in 6 US Cities

Objectives. We assessed the relation of childhood sexual abuse (CSA), intimate partner violence (IPV), and depression to HIV sexual risk behaviors among Black men who have sex with men (MSM).Methods. Participants were 1522 Black MSM recruited from 6 US cities between July 2009 and December 2011. Univariate and multivariable logistic regression models were used.Results. Participants reported sex before age 12 years with someone at least 5 years older (31.1%), unwanted sex when aged 12 to 16 years (30%), IPV (51.8%), and depression (43.8%). Experiencing CSA when aged 12 to 16 years was inversely associated with any receptive condomless anal sex with a male partner (adjusted odds ratio [AOR] = 0.50; 95% confidence interval [CI] = 0.29, 0.86). Pressured or forced sex was positively associated with any receptive anal sex (AOR = 2.24; 95% CI = 1.57, 3.20). Experiencing CSA when younger than 12 years, physical abuse, emotional abuse, having been stalked, and pressured or forced sex were positively associated with having more than 3 male partners in the past 6 months. Among HIV-positive MSM (n = 337), CSA between ages 12 and 16 years was positively associated with having more than 3 male partners in the past 6 months.Conclusions. Rates of CSA, IPV, and depression were high, but associations with HIV sexual risk outcomes were modest.Despite significant medical advances, the HIV epidemic remains a health crisis in Black communities. The Black population represents only 14% of the total US population but accounted for 44% of all new HIV infection (68.9 of 100 000) in 2010.1 Black men who have sex with men (MSM) are disproportionately impacted by HIV compared with other racial/ethnic groups of MSM.1,2 Male-to-male sexual contact accounted for 72% of new infections among all Black men.1 Young Black MSM (aged 13–24 years) have a greater number of new infections than any other age or racial group among MSM.1 Researchers have been challenged with developing HIV prevention strategies for Black MSM.3–7 Higher frequencies of sexual risk behaviors, substance use, and nondisclosure of sexual identities do not adequately explain this disparity.8,9 High rates of sexually transmitted infections (STIs), which facilitate HIV transmission, and undetected or late diagnosis of HIV infection only partially explain disproportionate HIV rates.8Researchers have begun to examine a constellation of health factors that may contribute to HIV among MSM. For example, syndemic theory or the interaction of epidemics synergistically, such as intimate partner violence (IPV) and depression, may help explain HIV-related sexual risk behaviors among Black MSM.9 Childhood sexual abuse (CSA), IPV, and mental health disorders including depression may comprise such a constellation and warrant further exploration.Experiences of CSA have been identified as being associated with negative sexual health outcomes, with MSM reporting higher CSA rates than the general male population.10–12 Men with CSA experiences are more likely than men without CSA experiences to engage in high-risk sexual behaviors,13–21 have more lifetime sexual partners,13–16 use condoms less frequently,13,14,16 and have higher rates of STIs,13,14,17 exchanging sex for drugs or money,13,14,17 HIV,13,14 alcohol and substance use,13–21 and depression.13–15,18,21 Such findings suggest that sexual risk reduction counseling may need to be tailored for MSM with CSA experiences.15Childhood sexual abuse histories have also been correlated with sexual revictimization, including IPV.22–24 One study with population-based estimates of CSA found that gay and bisexually identified men had higher odds of reporting CSA (9.5 and 12.8, respectively) compared with heterosexual men.25 For sexual minority men, CSA histories were associated with higher HIV and STI incidence.25 However, research examining CSA, revictimization, and sexual risk behaviors is lacking among Black MSM.In one existing study, Black and Latino MSM with CSA histories identified their trauma experiences as influencing their adult sexual decision-making.26 Among Black MSM in 2 additional studies, emotional distress and substance use were attributed to having CSA experiences (Leo Wilton, PhD, written communication, October 2, 2013).27 In an ethnically diverse sample of 456 HIV-positive MSM, CSA was associated with insertive and receptive condomless anal sex.19Similar to CSA, IPV has not been extensively examined among MSM or Black MSM,28 but may be associated with sexual risk behaviors. Intimate partner violence is defined as a pattern of controlling, abusive behavior within an intimate relationship that may include physical, psychological or emotional, verbal, or sexual abuse.29 Little research exists on IPV among same-sex couples despite incidence rates being comparable to or greater than that of heterosexual women.28,30–34 Important IPV information comes from the National Intimate Partner and Sexual Violence Survey, a nationally representative survey for experiences of sexual violence, stalking, and IPV among men and women in the United States.28 Among men who experienced rape, physical violence, or stalking by an intimate partner, perpetrator differences by gender were found among gay, bisexual, and heterosexual men; 78% of bisexual and 99.5% of heterosexual men reported having only female perpetrators, and 90.7% of gay men reported having only male perpetrators.28 Being slapped, pushed, or shoved by an intimate partner during their lifetime was reported by gay (24%), bisexual (27%), and heterosexual (26.3%) men.28Intimate partner violence has been linked to condomless anal sex, HIV infection, substance use, CSA, and depression.35–37 Being an HIV-positive MSM has been linked with becoming a victim of IPV.38,39 Welles et al. found that being an African American MSM who initially disclosed having male partners and early life sexual abuse experiences was associated with IPV victimization.39 Wilton found that a high percentage of Black MSM reported IPV histories: emotional abuse (48.3%), physical abuse (28.3%), sexual abuse (21.7%), and stalking abuse (29.2%; Leo Wilton, PhD, written communication, October 2, 2013). Such findings lend to the importance of exploring, both independently and together, the association of CSA and IPV with sexual risk behaviors.Some studies have reported the influence of mental health (e.g., depression) on sexual risk behaviors among MSM,9,40,41 whereas others have not corroborated such findings.42 Greater rates of depression among MSM than among non-MSM samples43–45 and elevated rates of depression and anxiety among Black MSM have been reported.46 The Urban Men’s Health Study, a cross-sectional sample of MSM in 4 US cities, did not find a significant relationship between high depressive symptoms and condomless anal sex.42 However, the EXPLORE study, a randomized behavioral intervention for MSM in 6 US cities, supported the association between moderate depressive symptoms and an increased risk for HIV infection.47 Moderate levels of depression and higher rates of sexual risk were also reported for HIV-infected MSM over time.48 Another study conducted with 197 Black MSM found that moderate depressive symptoms were associated with having condomless anal sex with a serodiscordant casual partner.49 These mixed findings support the need to better understand the relationship between the severity of depression (i.e., moderate vs severe) and HIV risk behaviors.The HIV Prevention Trials Network 061 study, also known as the BROTHERS (Broadening the Reach of Testing, Health Education, Resources, and Services) Project, was a multisite study to determine the feasibility and acceptability of a multicomponent intervention for Black MSM. The current analysis aims to assess the prevalence of CSA, IPV, and depressive symptomology, and examine the relationships between these factors and insertive and receptive condomless anal sex and number of sexual partners in a large cohort of Black MSM.     

Sexual Desire and Linguistic Analysis: A Comparison of Sexually-Abused and Non-Abused Women

Although studies have identified a relationship between a history of child sexual abuse (CSA) and problems with hypoactive sexual desire, little is known about the potential cognitive and affective mechanisms involved in the sexual desire of women with a history of CSA. In this study, 27 women with a history of CSA and 22 women with no history of abuse were asked to write about sexual and non sexual topics. The Linguistic Inquiry Word Count software program was used to compute the percentage of words that fell into positive emotions, negative emotions, body, and sex categories. As expected, women with a history of CSA used more negative emotions words when writing about sexual topics, but not non-sexual topics, compared to non-abused women. Women with a history of CSA also used more sex words when writing about the non-sexual topics compared to non-abused women. Frequencies of body and sex words used in the sexual texts were positively linked to levels of sexual desire function. This association was not different between women with and without a history of CSA. A history of CSA remained an independent predictor of levels of sexual desire dysfunction even when taking into consideration the language used in the sexual texts, indicating that there may be aspects of the sexual desire experienced by women with a history of CSA that differ from non-abused women that remain unexplored.     

Designing a VAR2CSA-based vaccine to prevent placental malaria

Placental malaria (PM) due to Plasmodium falciparum is a major cause of maternal, fetal and infant mortality, but the mechanisms of pathogenesis and protective immunity are relatively well-understood for this condition, providing a path for vaccine development. P. falciparum parasites bind to chondroitin sulfate A (CSA) to sequester in the placenta, and women become resistant over 1–2 pregnancies as they acquire antibodies that block adhesion to CSA. The protein VAR2CSA, a member of the PfEMP1 variant surface antigen family, mediates parasite adhesion to CSA, and is the leading target for a vaccine to prevent PM. Obstacles to PM vaccine development include the large size (∼350 kD), high cysteine content, and sequence variation of VAR2CSA. A number of approaches have been taken to identify the combination of VAR2CSA domains and alleles that can induce broadly active antibodies that block adhesion of heterologous parasite isolates to CSA. This review summarizes these approaches, which have examined VAR2CSA fragments for binding activity, antigenicity with naturally acquired antibodies, and immunogenicity in animals for inducing anti-adhesion or surface-reactive antibodies. Two products are expected to enter human clinical studies in the near future based on N-terminal VAR2CSA fragments that have high binding affinity for CSA, and additional proteins preferentially expressed by placental parasites are also being examined for their potential contribution to a PM vaccine.     

广州市青年男男性行为者儿童期性虐待经历对抑郁的影响

  目的  了解广州市青年男男性行为者(young men who have sex with men，YMSM)儿童期性虐待(childhood sexual abuse，CSA)经历和抑郁症状的情况，探讨儿童期性虐待对抑郁的影响。  方法  采用方便抽样的方法，在广州市招募在广州居住时间≥3个月，年龄18~24周岁的365名YMSM作为研究对象，通过电子问卷收集调查对象的人口学特征、寻找性伴方式、性取向、CSA经历和抑郁症状等信息。采用χ2检验比较不同特征YMSM的CSA经历和抑郁情况，采用多因素Logistic回归模型分析CSA经历对抑郁的影响。  结果  YMSM中CSA经历和抑郁症状报告率分别为31.51%(115/365)和47.95%(175/365)。初中及以下文化程度(75.00%)以及通过线下寻伴方式(62.22%)的YMSM抑郁症状报告率较高(χ2值分别为7.97，4.19，P值均 < 0.05)。调整了民族、户籍所在地、居住时间、学生、文化程度、个人月收入、性取向、寻伴方式等因素后，多因素Logistic回归模型显示有CSA经历(aOR=1.81，95%CI=1.12~2.93)的YMSM有抑郁症状的可能性高于无CSA经历者。  结论  广州市YMSM有CSA经历和抑郁症状的比例较高，CSA经历是抑郁症状的危险因素。应注重加强对YMSM的心理干预，尤其是有CSA经历的YMSM，从而减少抑郁症状的比例，提高该人群心理健康水平。     

广州市正常人群流行性脑脊髓膜炎抗体水平调查

广州市1967～1968年曾出现过一次流行性脑脊髓膜炎(流脑)流行[1].1985年始我市实施了A群流脑多糖体菌苗接种,流脑发病率明显下降.为了掌握广州市人群流脑抗体水平情况,我们于1998～1999年对494名正常人群血清进行流脑A群杀菌抗体水平检测,结果报告如下.     

中国6省市2508名大学生儿童期性虐待经历回顾性调查

目的 了解大学生中儿童期性虐待发生情况,探讨性虐待经历与大学生心理健康的关联.方法 采用自填式问卷,于2003年11月至2004年3月对北京、河北、山西、江苏、陕西、安徽6省市6所普通高校中2508名大学生(女生1360人,男生1148人)童年期性虐待经历进行不记名回顾性调查.结果 2508名大学生中,有24.8%的女生和17.6%的男生报告16岁前曾经历过1项或1项以上的性虐待,其中包括非身体接触的性虐待(女生20.0%,男生14.6%)和包括触摸在内的身体接触的性虐待(女生14.1%,男生7.8%).儿童期性虐待经历与是否为独生子女、家庭居住地是农村还是非农村、父母亲文化程度等没有明显的关联.与没有童年期性虐待经历的学生比较,有童年期性虐待经历的学生躯体化症状、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性症状等因子均分偏高.结论 童年期性虐待经历与大学生心理健康问题相关.     

Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey

OBJECTIVES: This study examined the relationship between child sexual abuse (CSA) and subsequent onset of psychiatric disorders, accounting for other childhood adversities, CSA type, and chronicity of the abuse. METHODS: Retrospective reports of CSA, other adversities, and psychiatric disorders were obtained by the National Comorbidity Survey, a nationally representative survey of the United States (n = 5877). Reports were analyzed by multivariate methods. RESULTS: CSA was reported by 13.5% of women and 2.5% of men. When other childhood adversities were controlled for, significant associations were found between CSA and subsequent onset of 14 mood, anxiety, and substance use disorders among women and 5 among men. In a subsample of respondents reporting no other adversities, odds of depression and substance problems associated with CSA were higher. Among women, rape (vs molestation), knowing the perpetrator (vs strangers), and chronicity of CSA (vs isolated incidents) were associated with higher odds of some disorders. CONCLUSIONS: CSA usually occurs as part of a larger syndrome of childhood adversities. Nonetheless, CSA, whether alone or in a larger adversity cluster, is associated with substantial increased risk of subsequent psychopathology.     

Dissociation During Sex and Sexual Arousal in Women With and Without a History of Childhood Sexual Abuse

Women with a history of childhood sexual abuse (CSA) experience dissociative symptoms and sexual difficulties with greater frequency than women without a history of CSA. Current models of sexual dysfunction for sexual abuse survivors suggest that dissociation may mediate the relationship between CSA and sexual arousal difficulties. Dissociation, however, is often conceptualized as a single construct in studies of CSA and not as separate domains as in the dissociation literature. In the present study, women with (CSA, N = 37) and without (NSA, N = 22) a history of CSA recruited from the community were asked to indicate the frequency and intensity of their experience in two dissociation subgroups, derealization and depersonalization, during sex with a partner and in their daily life. Findings showed that, in the NSA group, more depersonalization during sex with a partner was associated with lower sexual arousal functioning. However, for both the NSA and CSA groups, more derealization during sex was associated with higher sexual arousal functioning. No measure of dissociation was significantly associated with sexual responses in the laboratory. These findings highlight the importance of distinguishing between different forms of dissociation (i.e., derealization and depersonalization) in the study of sexual arousal functioning. In addition, the findings challenge the notion that dissociation is a main predictor of sexual arousal problems in survivors of CSA and suggest that a more nuanced relationship may exist.