This study examined the role of adulthood adversities in the relationship between childhood adversities and depression in 117 HIV-positive Black men who have sex with men and women (MSMW) and who have histories of childhood sexual abuse (CSA). Men were participants in the Enhanced Sexual Health Intervention for Men, a 6-session health intervention, and, at baseline, reported their experiences of CSA, childhood adversities, perceived discrimination, chronic stress, social support, and depressive symptoms. The relationship between childhood adversities, including CSA, and depression was mediated by experiences with racial and HIV discrimination, R² = .25, F(3, 112) = 12.67, p < .001, and chronic stress, R² = .17, F(3, 112) = 7.41, p < .001. Social support moderated the mediated effects of both racial and HIV discrimination, b = -.154, t(111) = -2.82, p < .01, and chronic stress, b = -.019, t(111) = -3.759, p < .01. Men's early adverse experiences were predictive of depression in adulthood; however, this relationship was largely affected by adulthood experiences, specifically discrimination, high chronic stress, and low social support. These findings illustrate pathways by which Black MSMW's early vulnerability for depression is either exacerbated or attenuated by their experiences as adults.