The findings support substantial portions of the theoretical model, with important differences observed between secondary and primary partner models; primary and secondary sexual relationships represent broad distinctions in types of close relationships. By definition, primary relationships involve a greater degree of commitment and love than secondary relationships; secondary sexual relationships encompass a more diverse range of sexual partnerships and tend to be more transitory, involving more occurrences of high-risk sexual behavior. Results show that CSA contributes to the ongoing HIV epidemic among men-who-have-sex-with-men (MSM) by distorting or undermining critical motivational, coping, and interpersonal factors that influence adult sexual risk behavior. The type of adult relationships in which men engage serves as markers for adult CSA-related problems. Models were tested that explored potential mediators of CSA and adult sexual health, such as HIV/STI related risk behaviors. The secondary sexual partners model was the most complex with multiple pathways leading from CSA to high-risk sex. The primary sexual partners model was less complex with only one significant over-arching pathway observed linking CSA to high-risk sex. Explanations for these differences by partnership type are discussed and detailed discussions of specific pathways in the context of current theory and HIV prevention strategies are provided. Data were collected from an Urban Men’s Health Study of 1,078 participants who had reported CSA in a prior household survey. Table, Figures, and references