Service Provider Interpretations of Childhood Sexual Experiences Among Sexual Minority Men

In this study, we report findings from a directed content analysis of service provider (SP) interpretations of early sexual experiences depicted in vignettes created from retrospective interviews with Black sexual minority men. Specifically, we explore whether SP recognize circumstances of abuse in the vignette narrators' sexual histories. Data for this analysis come from in-person qualitative interviews conducted with 35 providers working in substance abuse treatment and allied health service settings (e.g., mental health, HIV prevention and outreach) across the New York City area. The interviewees were asked to evaluate each of five vignettes depicting a range of early sexual experiences as described by the narrators [e.g., unwanted experiences with a male or female consistent with definitions of childhood sexual abuse (CSA), consensual sex with an older male or female]. Based on analysis of provider responses to the vignettes, we found that most recognized differences in age and authority as abuse indicators. Many of the providers struggled with assertions by vignette narrators that they had consented to the encounters-specifically those that could be considered abusive. Findings highlight areas to focus on in developing additional provider training, including the challenges of defining CSA, age and other factors that influence consent, and how cultural background and sexual minority status may shape men's appraisals of their experiences. Impact Statement Substance abuse treatment and other allied health services providers evaluated Black sexual minority men's descriptions of early sexual experiences. Most providers recognized obvious indicators of abuse, but struggled with men's descriptions of problematic encounters as consensual. Findings suggest the need for additional provider training on issues of consent and on the effects of cultural background and sexual minority status on men's appraisals of their experiences.