Adverse Childhood Experiences and Behaviors Associated with HIV Acquisition Among Adult Sexual Minority Men in the United States

BACKGROUND: Adverse childhood experiences (ACEs) have been associated with HIV acquisition among sexual minority men; however, research examining the mechanisms through which ACEs affect behaviors associated with HIV acquisition among this population, as well as variation by race and ethnicity, is limited. METHODS: This study sought to investigate the relationship between ACEs and behaviors associated with HIV acquisition, including potential differences in ACE score by race and ethnicity, and to assess the potential mediating effects of depression, substance use, and binge drinking, using bivariate analyses, traditional linear regression, and Sobel tests (N = 7871). RESULTS: Total ACE score was significantly associated with behaviors associated with HIV acquisition (b=0.042). Additionally, total ACE score and behaviors associated with HIV acquisition were indirectly associated through both depression and substance use. On average, racial and ethnic minority participants reported higher ACE scores compared to their non-racial or ethnic minority peers. CONCLUSION: Findings should inform future HIV prevention interventions for sexual minority men by intentionally addressing the psychosocial impacts of childhood trauma, particularly among racial and ethnic minority individuals.