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Sexual abuse may explain high HIV rates in gay men

We must address trauma that undermines self-esteem, good judgment

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September 27 is National Gay Men’s HIV Awareness Day.

We’d been messing around since I was about 10 years old. I figured sex with him and his three younger brothers next door was just a part of our friendship, along with our hikes to Bluff Point, on Long Island Sound, and neighborhood kickball, baseball, football, and foursquare games.

Besides, I enjoyed it a lot. I never felt consciously traumatized.

It would take a 2005 HIV diagnosis to open my mind to how my experience of childhood sexual abuse, and the multiple traumas I experienced throughout my life, undermined my self-esteem and good judgment and put me in the way of the same lethal microbe that killed so many of my friends.

The American Academy of Experts in Traumatic Stress (AAETS) says that 30 percent of all male children are molested in some way. There is a well-documented correlation between sexual abuse and later promiscuity. PTSD, depression, poor self-esteem, dissociative disorders, and anxiety are among the other effects of CSA. Sexual abuse survivors often equate sexual desirability with self-worth—and use sex as an analgesic to blunt the edge of shame that is another insidious effect of CSA.

I know these things, not only from reading about them in the research literature, but because they have played out in my own life—and in the lives of so many gay men.

Behavioral scientists have wrung their hands for more than three decades trying to understand why gay men seem so disproportionately vulnerable to HIV. Recent research makes it abundantly clear that trauma, specifically from CSA, is almost certainly the long-overlooked answer.

Consider: Harvard researchers have found that up to 46 percent of gay and bisexual men who report condomless anal sex—the principal act by which HIV is transmitted between men—were sexually abused as boys.

“That is a huge number,” said Conall O’Cleirigh, a staff clinical psychologist in the psychiatry department at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard. His research on gay men has found that the same mental health issues that can put someone at risk for HIV can also prevent someone living with the virus from adhering to his treatment.

In a national study of 1,552 black gay and bisexual men, O’Cleirigh and his colleagues found that men who experienced CSA—or physical or emotional abuse, or stalking, or being pressured or forced to have sex—when they were younger than 12 years old had more than three male partners in the past six months. The men who had been forced or pressured to have sex as boys were likely to have receptive anal sex.

In another study of 162 men with CSA histories, participants reporting sexual abuse by family members were 2.6 times more likely to abuse alcohol, twice as likely to have a substance use disorder, and 2.7 times more likely to report a sexually transmitted infection in the past year. Not only that, but men whose abuser penetrated them were more likely to have PTSD, recent HIV sexual risk behavior, and a greater number of casual sexual partners. Physical injury and intense fear increased the odds for PTSD even more.

“Having that history is repeatedly associated in every sample of gay men with increased likelihood of being HIV-positive,” said O’Cleirigh. He said that since CSA is “very, very common in gay and bisexual men” it appears to be one of the most significant vulnerabilities that accounts for the disproportionately high rate of HIV among gay men.

Prevention educators long have wanted to believe that handing out condoms, or, more recently, the HIV medication Truvada used as pre-exposure prophylaxis to prevent HIV infection, should suffice for men at the highest risk who engage in unprotected anal sex with partners of unknown HIV status. But increasing rates of new HIV infection among gay men—the only U.S. population with increasing, rather than declining, rates—are proof that condoms and PrEP alone aren’t enough.

The only way to arrest the spread of HIV among gay men is to address the trauma that undermines their self-esteem and good judgment.

An effective risk-reduction/health-promotion intervention that addresses the effects of childhood sexual abuse could help make gay male survivors more conscious of what they are doing and where it’s coming from in their psyche. It could also finally reduce the “hardcore” of gay men beyond the reach of more traditional prevention efforts.

At Boston’s Fenway Health, O’Cleirigh helped recruit the nearly 5,000 gay and bisexual men who participated in Project Thrive, an intervention aimed at helping gay men who experienced CSA to increase their coping skills and ability to be more present in—rather than dissociating from (a common effect of CSA)—their immediate situation, and provide specific skills to evaluate and reassess these situations.

“Treatments [counseling and therapy] are geared toward giving the men a more realistic sense of the world,” said O’Cleirigh, which is an important ingredient of resilience. “As we say to our clients, we can’t change the fact that you were abused, but you can change.”

Healed gay men protect themselves and their partners, and take their meds if they are positive.

The message for this National Gay Men’s HIV-AIDS Awareness Day should be that helping gay survivors of childhood sexual abuse to heal from trauma can profoundly reshape the way they think and make choices about sex—and about their health.

This is how new HIV infections among the “hardcore” will stop, and the surest way for those of us living with the virus to stay healthy.

 

John-Manuel Andriote is a Connecticut-based writer.

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Opinions

The felon in the White House must be stopped

Are there any decent Republican members of Congress left?

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President Donald Trump (Screen capture via White House/YouTube)

We are up shit’s creek if the felon in the White House actually thinks he has a Nobel Peace Prize. If he believes he deserves one, or Venezuelan opposition leader Maria Corina Machado had any other reason to give him hers, than it was easier, and less degrading, than going on her knees to him, as a number of men already have. I don’t know if she understood how many millions the medal could be worth. Instead, she could have used it for her people, if she didn’t want to keep it. 

Machado was awarded the Nobel Prize for her work for the Venezuelan people. She spoke up for them, and fought for them. The felon couldn’t care less about them. He proved that by invading, and then supported Maduro’s vice president as president. He said he, and his fascist cohorts, would run the country, and is now stealing their oil and personally deciding what to do with it. After U.S. troops captured Venezuelan President Nicolás Maduro, Trump said, Venezuelan opposition leader Maria Corina Machado “doesn’t have the support within Venezuela to be its next leader, she was not consulted prior to the operation.” He went on to say, “I think it would be very tough for her to be the leader. She doesn’t have the support within or the respect within the country.” This is the slime bag she gave her Nobel Peace Prize medal to. I hope she is not naïve enough to believe he really cares about her, or her countrymen, and women. 

Trump is vile, sick, and mentally deranged. He is threatening foes and allies alike. They see bending a knee to him only works for the moment, but has no long-term impact on his tiny brain. Today, he is threatening Greenland, and our NATO allies are moving their military to Greenland to protect it against the United States. Now he is threatening them with new tariffs. That would have once been unfathomable. He is saber rattling over Iran, Colombia, even Mexico. He is bombing Nigeria and Syria. 

If that weren’t enough, he threatens to use the Insurrection Act to send the military into cities here. He has already sent in thousands of ICE agents. ICE is classified as a federal law enforcement agency under the Department of Homeland Security. They have authority to arrest, detain, and investigate immigration violations. However, the law is clear; ICE agents do not have unlimited power. They face significant constitutional restrictions that many people don’t realize, especially when it comes to entering homes and private spaces. But what is clear, in Minneapolis today, some of the agents are acting like the Gestapo. They are smashing car windows, pulling people out of their cars, invading homes, and workplaces, all without first having any proof the people they are going after are guilty of anything. I believe we need fair immigration laws, and they should be enforced. But this is clearly not what the felon is doing. The felon in the White House and his incompetent stooge at Homeland Security, Kristi Noem, who has no idea what the hell she is doing, are acting egregiously, and making a mockery of our democracy.  

The president, Noem, Hegseth, Bondi, and the other incompetents in the felon’s Cabinet, simply pretend to forget the history of the United States. They don’t want to accept the truth; we are a nation of immigrants. It is immigrants who built our country, and are still building it. My parents were immigrants escaping from Hitler, and they came here and built a life, and in doing so, added to the greatness of our country. I want every person around the world who needs to escape from dictators, and despots, to be able to do the same as my parents did. We need to build an immigration system that allows them to do that. Instead, because of what this felon is doing, we are seeing American citizens thinking of leaving this country, and looking for asylum in others. That is really sick, but it’s happening.   

Sitting in the Oval Office today we have a felon who is reveling in becoming the war president. He is taking the United States down an incredibly dangerous path, threatening our own citizens with violence here at home, and doing the same to our allies around the world. He, and the incompetents and fascists surrounding him, need to be stopped. If there are any decent Republican members of Congress left, they need to join with Democrats, and the voters, to stop him.


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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Commentary

The power of no

Pick one priority this year, not 10

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(Photo by Damian Palus/Bigstock)

January arrives with optimism. New year energy. Fresh possibilities. A belief that this could finally be the year things change. And every January, I watch people respond to that optimism the same way. By adding.

More workouts. More structure. More goals. More commitments. More pressure to transform. We add healthier meals. We add more family time. We add more career focus. We add more boundaries. We add more growth. Somewhere along the way, transformation becomes a list instead of a direction.

But what no one talks about enough is this: You can only receive what you actually have space for. You don’t have unlimited energy. You have 100 percent. That’s it.  Not 120. Not 200. Not grind harder and magically find more.

Your body knows this even if your calendar ignores it. Your nervous system knows it even if your ambition doesn’t want to admit it. When you try to pour more into a cup that’s already full, something spills. Usually it’s your peace. Or your consistency. Or your health.

What I’ve learned over time is that most people don’t need more motivation. They need clarity. Not more goals, but priority. Not more opportunity, but discernment.

So this January, instead of asking what you’re going to add, I want to offer something different. What if this year becomes a season of no.

No to things that drain you. No to things that distract you. No to things that look good on paper but don’t feel right in your body. And to make this real, here’s how you actually do it.

Identify your one true priority and protect it

Most people struggle with saying no because they haven’t clearly said yes to anything first. When everything matters, nothing actually does. Pick one priority for this season. Not 10. One.  Once you identify it, everything else gets filtered through that lens. Does this support my priority, or does it compete with it?

Earlier this year, I had two leases in my hands. One for Shaw and one for National Landing in Virginia. From the outside, the move felt obvious. Growth is celebrated. Expansion is rewarded. More locations look like success. But my gut and my nervous system told me I couldn’t do both.

Saying no felt like failure at first. It felt like I was slowing down when I was supposed to be speeding up. But what I was really doing was choosing alignment over optics.

I knew what I was capable of thriving in. I knew my limits. I knew my personal life mattered. My boyfriend mattered. My family mattered. My physical health mattered. My mental health mattered. Looking back now, saying no was one of the best decisions I could have made for myself and for my team.

If something feels forced, rushed, or misaligned, trust that signal. If it’s meant for you, it will come back when the timing is right.

Look inside before you look outside

So many of us are chasing who we think we’re supposed to be— who the city needs us to be. Who social media rewards. Who our resume says we should become next. But clarity doesn’t come from noise. It comes from stillness. Moments of silence. Moments of gratitude. Moments where your nervous system can settle. Your body already knows who you are long before your ego tries to upgrade you.  

One of the most powerful phrases I ever practiced was simple: You are enough.

I said it for years before I believed it. And when I finally did, everything shifted. I stopped chasing growth just to prove something. I stopped adding just to feel worthy.  I could maintain. I could breathe. I could be OK where I was.

Gerard from Baltimore was enough. Anything else I added became extra.

Turning 40 made this clearer than ever. My twenties were about finding myself. My thirties were about proving myself. My forties are about being myself.

I wish I knew then what I know now. I hope the 20 year olds catch it early. I hope the 30 year olds don’t wait as long as I did.

Because the only way to truly say yes to yourself is by saying no first.

Remove more than you add

Before you write your resolutions, try this. If you plan to add three things this year, identify six things you’re willing to remove. Habits. Distractions. Commitments. Energy leaks.

Maybe growth doesn’t look like expansion for you this year. Maybe it looks like focus. Maybe it looks like honoring your limits. January isn’t asking you to become superhuman. It’s asking you to become intentional. And sometimes the most powerful word you can say for your future is no.

With love always, Coach G.


Gerard Burley, also known as Coach G, is founder and CEO of Sweat DC.

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Greenland

The Greenland lesson for LGBTQ people

Playbook is the same for our community and Europeans

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(Photo by Maridav/Bigstock)

I understand my own geopolitical limits and don’t pretend to know how Europeans should respond to U.S. threats to seize Greenland or retaliate against anyone who opposes them. However, as I mentioned in March, it’s clear that for Europeans and LGBTQ+ people alike, hug-and-kiss diplomacy is over.

In practice, that means responding to the U.S. administration’s provocations with dialogue, human‑rights rhetoric, and reasoning may now be counterproductive. It looks weak. At some point, Europeans will have to draw a line and show how bullying allies and breaking international agreements carry a cost — and that the cost is unpredictable. On the surface, they have few options; like LGBTQ+ communities, they are very behind in raw power and took too long to wake up. But they still have leverage, and they can still inflict harm.​

Maybe it is time for them to call the bluff. America has a great deal to lose, not least its reputation and credibility on the world stage. Stephen Miller and Pete Hegseth, with all their bravado, obviously underestimate both the short‑ and long‑term geopolitical price of ridicule. Force the United States to contemplate sending troops into an ally’s territory, and let the consequences play out in international opinion, institutions, and markets.​

In the United States, LGBTQ+ communities have already endured a cascade of humiliations and live under constant threat of more. In 2025 our symbols and heroes were systematically erased or defaced: the USNS Harvey Milk was quietly renamed after a straight war hero, Admiral Rachel Levine’s title and image were scrubbed from official materials, Pride flags were banned from public buildings, World AIDS Day events were defunded or stripped of queer content, the Orlando memorial and other sites of mourning were targeted, the U.S. lead a campaign against LGBTQ+ language at the U.N., and rainbow crosswalks were literally ripped up or painted over. We cannot simply register our distress; we must articulate a response.​

In practice, that means being intentional and focused. We should select a few unmistakable examples: a company that visibly broke faith with us, a vulnerable political figure whose actions demand consequences, and an institution that depends on constituencies that still need us. The tools matter less than the concentration of force — boycotts, shaming, targeted campaigning all qualify — so long as crossing certain lines produces visible, memorable costs.​

A friend suggested we create what he called a “c***t committee.” I liked the discipline it implies: a deliberate, collective decision to carefully select a few targets and follow through. We need a win badly in 2026.

These thoughts are part of a broader reflection on the character of our movement I’d like to explore in the coming months. My friends know that anger and sarcasm carried me for a long time, but eventually delivered diminishing returns. I am incrementally changing these aspects of my character that stand in the way of my goals. The movement is in a similar place: the tactics that served us best are losing effectiveness because the terrain has shifted. The Greenland moment clarifies that we must have a two-pronged approach: building long-term power and, in the short term, punching a few people in the nose.

Fabrice Houdart published this column on his weekly Substack newsletter. The Washington Blade has republished it with his permission.

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