Citation

Sweet T, Polansky M, Welles SL. J. Acquir. Immune Defic. Syndr. (LWW) 2013; 62(1): 81-89.

Affiliation

Drexel University School of Public Health, 1505 Race Street, Philadelphia, PA 19145.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/QAI.0b013e318273b0c7

PMID

23018374

Abstract

BACKGROUND:: Individuals who experience Childhood Sexual Abuse (CSA) have higher rates of unsafe sexual behaviors and/or HIV or sexually transmitted infection (STI) incidence. Accordingly, sexual minorities also have higher rates of HIV/STI incidence compared to heterosexuals among those abused as children and those that were not. However, little is known concerning the mechanisms by which CSA confers increased sexual risk. METHODS:: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions, we prospectively analyzed the relationship between CSA and recent incident HIV/STIs at Wave 2 (2004-2005) while examining mental health and substance use disorders reported during Wave 1 (2001-2002) as putative mediators. RESULTS:: For women, mental health disorders mediated 35% of the effect of CSA on the risk of HIV/STI. Neither alcohol nor drug use disorders were mediators for HIV/STI risk due to CSA in women. For heterosexual men, mental health disorders (90%), and alcohol (24%) and drug use (46%) disorders mediated some or all of the HIV/STI risk. None of the disorders mediated the risk of HIV/STI in sexual minority men, who had the highest HIV/STI risk among the groups measured. CONCLUSIONS:: CSA is a strong risk factor for risky sexual behavior in adulthood. Our findings indicate that there may be multiple causal pathways from CSA to HIV risk, with different mediators to be targeted for intervention. These differences need to be further studied in order to design appropriate HIV interventions to reduce the high risk behaviors among individuals who were sexually abused as children.

Language: en