Association of CAI Vulnerability and Sexual Minority Victimization Distress Among Adolescent Men Who Have Sex With Men

Adolescent men who have sex with men (AMSM) are at high HIV risk. Condomless anal intercourse (CAI) increases HIV risk and has been associated with interpersonal power imbalances, such asasymmetries in decision-making authority, social status, and emotional dependence, between male sexualpartners. AMSM experience high levels of psychological and physical victimization due to their sexualminority status. Sexual minority victimization (SMV) is similarly associated with low interpersonalpower and may relate to the extent to which AMSM are vulnerable to partner influences to engage inCAI. This online survey study of AMSM 14 –17 years old (N = 143) tested the hypothesis thatexperiences and attitudes reflecting vulnerability to partner CAI influence (CAI Vulnerability) anddistress in response to experienced sexual minority victimization (SMV Distress) would be positivelyassociated with participant and partner condom nonuse during anal sex (CAI frequency). Approximately35% reported they or their partner(s) had never or rarely used a condom. Positive correlations were foundamong partners’ CAI frequency during sex with the participant, CAI Vulnerability, and SMV Distress.Multiple regression indicated CAI Vulnerability significantly accounted for the relation between SMVDistress and partner’s CAI frequency. Findings suggest that distress in response to SMV may beassociated with a diminished sense of interpersonal control resulting in CAI Vulnerability and subsequentmore frequent instances of partner CAI. HIV prevention strategies designed to increase condom useamong AMSM have the potential to benefit from procedures aimed at increasing interpersonal sexualassertiveness and decreasing distress associated with sexual minority victimization.