Background: Childhood maltreatment, particularly sexual abuse, has been found to be associated with sexual risk behaviors later in life. We aimed to evaluate associations between a broad range of childhood traumas and sexual risk behaviors from adolescence into adulthood.
Methods: Using data from Waves I, III and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we used logistic regression to estimate the unadjusted odds ratio (OR) and adjusted OR (AOR) for associations between 9 childhood traumas and a cumulative trauma score and three sexual risk outcomes (multiple partnerships, sex trade involvement, and sexually transmitted infection [STI]) in adolescence, young adulthood, and adulthood. We also examined modification of these associations by gender.
Results: Associations between cumulative trauma score and sexual risk outcomes existed at all waves, though were strongest during adolescence. Dose-response–like relationships were observed during at least 1 wave of the study for each outcome. Violence exposures were strong independent correlates of adolescent sexual risk outcomes. Parental binge drinking was the only trauma associated with biologically confirmed infection in young adulthood (AOR, 1.46; 95% confidence interval [CI], 1.01–2.11), whereas parental incarceration was the trauma most strongly associated with self-reported STI in adulthood (AOR, 1.70; 95% CI, 1.11–2.58). A strong connection was also found between sexual abuse and sex trade in the young adulthood period (AOR, 2.17; 95% CI, 1.43–2.49).
Conclusions: A broad range of traumas are independent correlates of sex risk behavior and STI, with increasing trauma level linked to increasing odds of sexual risk outcomes. The results underscore the need to consider trauma history in STI screening and prevention strategies.
A nationally representative study found that a broad range of childhood traumas are associated with sexual risk behavior and sexually transmitted infection from adolescence into adulthood.
From the *New York University School of Medicine; †Department of Population Health, New York University School of Medicine, New York, NY; and ‡Department of Psychology, Division of Social Sciences, University of Hawaii, Honolulu, Hawaii
This work was supported by National Institute on Drug Abuse study (R01DA036414: Longitudinal Study of Trauma, HIV Risk, and Criminal Justice Involvement) and The New York University Center for Drug Use and HIV/HCV Research (P30DA011041). This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.
This study was supported by NIDA DA036414 (PI: Khan). Dr. Khan was supported by the Dissemination and Implementation Core of the NYU Center for Drug Use and HIV Research (CDUHR, P30 DA011041-16).
Conflict of Interest: None declared.
Correspondence: Maria R. Khan, PhD, MPH, Department of Population Health, New York University School of Medicine, 227 East 30th St. 628Q, New York, NY 10016. E-mail: Maria.firstname.lastname@example.org.
Received for publication January 18, 2017, and accepted April 17, 2017.