(PS5-91) Relevance of Resiliency: Highlighting Protective Factors that Predict Adult Quality of Life among Men who have Sex with Men with Histories of Childhood Sexual Abuse

Introduction: Childhood sexual abuse (CSA) is a prevalent trauma that can lead to poor mental health, physical health, and quality of life in adulthood. Among men who have sex with men (MSM), estimated rates of CSA are as high as 39.7%. Considering the potentially deleterious effects of CSA among MSM, the primary aim of this secondary analysis is to identify potential resiliency factors that may protect adulthood quality of life among MSM with histories of CSA.

Methods: Data for this study were collected as part of a larger randomized controlled clinical trial. HIV uninfected MSM with a history of CSA and multiple recent episodes of condomless anal/vaginal intercourse were randomized to a psycho-social intervention that integrated sexual risk reduction counseling with treatment modalities from cognitive processing therapy and cognitive behavioral therapy or treatment as usual. The current analysis utilized the baseline data of MSM with reported history of CSA (N = 288). Bivariate and multivariable linear regressions were conducted in SPSS to assess the associations between self-esteem (the Rosenberg Self-Esteem Scale), adaptive coping (the Brief COPE), and distress tolerance (the Distress Tolerance Scale) with adulthood quality of life (the Quality of Life Index). All models included age, race, ethnicity, income, and education as covariates.

Results: Adjusted bivariate regression models demonstrated that higher reported self-esteem (b = 0.171, SE = 0.013, β = 0.647, p < 0.001), adaptive coping skills (b = 0.787, SE = 0.164, β = 0.283, p < 0.001), and distress tolerance (b = -0.765, SE = 0.111, β = -0.400, p < 0.001) were significantly associated with greater adulthood quality of life. An adjusted multiple regression model that included all the resilience factors identified self-esteem as a unique significant predictor of greater adulthood quality of life, predicting outcomes over and above the effects of adaptive coping and distress tolerance (b = 0.156, SE = 0.016, β = 0.591, p < 0.001).

Discussion: Findings highlight the direct protective effects of self-esteem, adaptive coping, and distress tolerance on quality of life for MSM with histories of CSA. These results suggest the need for more strength-based approaches to improving quality of life among this population. Further, this study indicates that self-esteem serves as a unique pathway to adulthood quality of life among MSM with histories of CSA, suggesting treatment targets for future clinical practice. These findings suggest that interventions for MSM with CSA histories could incorporate self-esteem building strategies, such as cognitive restructuring or self-compassion techniques, to promote positive outcomes and overall wellbeing.