Do Adverse Childhood Experiences Impact PrEP Uptake in Young Adulthood?

Rates of testing for HIV, as well as PrEP uptake, remain suboptimal in MSM of color.

Prior research has demonstrated that gay, bisexual and other men who have sex with men (MSM) who have experienced adverse childhood events (ACEs) such as sexual abuse are significantly more likely to report HIV-related outcomes.

However, despite recent research, there has been no established association between ACE exposure and HIV testing, which is typically how individuals begin pre-exposure prophylaxis (PrEP).

Investigators from the CUNY School of Medicine, in collaboration with SUNY Binghamton, have conducted a study which sought to further understand this association.

The data was presented at the 11th International AIDS Society Conference on HIV Science.

For the study, the team of investigators used baseline data from the NIH-funded randomized, attention-control trial of an HIV self-testing intervention for young, Black/African-American MSM called TRUST.

Included in the study were 372 HIV-negative, MSM of color. Participants were asked to recall if any sexual violence experiences (SVEs), including their first experience of anal sex, were forced, coerced, non-consensual or for survival.

Results from the study showed that nearly a third of the sample had experienced forced or pressured first sexual experiences. Nearly two-thirds reported a sexual experience prior to the age of 18 with a partner 5 or more years older that was forced, coerced or otherwise unwanted.

Additionally, the bivariate analyses demonstrated no associations between SVE and recent HIV testing or PrEP use among the participants.

“Although no associations were identified between childhood/adolescence SVEs and HIV testing and PrEP uptake in later life, provider knowledge of exposures is needed to deliver optimal, trauma-informed sexual health care to MSM of color,” the authors wrote. “More research is needed to determine whether experiences of adulthood violence and/or an accumulation of childhood SVEs/ACEs over time relate to multiple HIV prevention behaviors among MSM of color.”