Long-term health outcomes of childhood sexual abuse and peer sexual contact among an urban sample of behaviourally bisexual Latino men

While previous research indicates high rates of childhood sexual abuse among Latino men who have sex with men, few studies have examined the long-term health outcomes of childhood sexual abuse specifically among behaviourally bisexual Latino men. In a sample of 148 behaviourally bisexual Latino men in New York City, we examined associations between childhood sexual abuse and multiple dimensions of adult health: sexual risk behaviours; sexually transmitted infections incidence; polydrug use; depressive symptoms; and perceived stress. We compared outcomes between those with histories of childhood sexual abuse, those reporting peer sexual contact prior to age 13 and those with no sexual contact prior to age 13. Over one-fifth (22.3%) reported a history of childhood sexual abuse, which was significantly associated with engaging in receptive condomless anal intercourse (aOR = 3.59, p < .01, SE = 2.0), high perceived stress (aOR = 2.48, p < .06, SE = 1.13) and clinically significant depressive symptoms (aOR = 2.7, p < .05, SE = 1.25). Across all variables, peer sexual contact did not impact these outcomes, underscoring a key distinction between abusive and non-abusive early sexual experiences. We recommend that sexual abuse prevention policies and programmes better engage Latino youth, and that practitioners serving this population across diverse areas of practice incorporate childhood sexual abuse screening and culturally appropriate treatment and care into practice.     

Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey

OBJECTIVES: This study examined the relationship between child sexual abuse (CSA) and subsequent onset of psychiatric disorders, accounting for other childhood adversities, CSA type, and chronicity of the abuse. METHODS: Retrospective reports of CSA, other adversities, and psychiatric disorders were obtained by the National Comorbidity Survey, a nationally representative survey of the United States (n = 5877). Reports were analyzed by multivariate methods. RESULTS: CSA was reported by 13.5% of women and 2.5% of men. When other childhood adversities were controlled for, significant associations were found between CSA and subsequent onset of 14 mood, anxiety, and substance use disorders among women and 5 among men. In a subsample of respondents reporting no other adversities, odds of depression and substance problems associated with CSA were higher. Among women, rape (vs molestation), knowing the perpetrator (vs strangers), and chronicity of CSA (vs isolated incidents) were associated with higher odds of some disorders. CONCLUSIONS: CSA usually occurs as part of a larger syndrome of childhood adversities. Nonetheless, CSA, whether alone or in a larger adversity cluster, is associated with substantial increased risk of subsequent psychopathology.     

某高等职业学院女生儿童期性虐待情况

目的了解高等职业学院女生儿童期性虐待发生情况,探讨性虐待对成年女生心理行为的影响。方法采用自制性虐待问题问卷及症状自评量表,对某高等职业学校701名女生儿童期性虐待经历及其行为问题进行调查。结果被调查的701名女生中有155人(22.11%)回答18岁以前曾经历过至少1次1种或多种性虐待,其中98人(13.98%)回答经历过至少1次1种性虐待,57人(8.13%)回答经历过多种性虐待;以其经历过的最严重的性虐待进行统计,有75人(10.70%)被非身体接触性性虐待,有80人(11.41%)被身体接触性性虐待,其中包括26人(3.71%)被试图性交和8人(1.14%)被强行性交。16岁以前有117人(16.69%)曾经历过性虐待。与没有性虐待经历的女生比较,有儿童期性虐待经历的女生行为症状因子得分高,差异有统计学意义。结论应重视女童性虐待问题,儿童期性虐待经历是导致成年后心理问题的重要因素。     

男男性行为者儿童期性虐待经历对艾滋病高危行为及心理影响

目的 探讨男男性行为者(MSM)儿童期性虐待(CSA)经历对其成年后艾滋病高危行为及心理影响状况.方法 采用定向抽样("滚雪球")法进行横断面调查.对9城市2147例MSM的有效匿名问卷进行分析,比较CSA经历者与无此经历者艾滋病高危行为及心理影响差异.结果 CSA经历者累计同性性伴数(中位数20.0个)、累计同性肛交性伴数(中位数10.0个)、累计女性性伴数(中位数3.0个)、近6个月同性肛交性伴数(中位数3.0个)均高于无此经历者;近1年曾参加群交百分率(30.8%)、向同性"买"性百分率(19.2%)、性交出血百分率(36.7%)、去外地并与陌生男性性交百分率(37.3%)均高于无此经历者;近一次肛交时安全套使用率(67.3%)低于无此经历者;认为暴露性取向会明显受到歧视和严重伤害百分率(75.6%)、曾有过强烈的自杀念头百分率(34.7%)、曾有过自杀行为百分率(24.3%)均高于无此经历者.结论 CSA经历增加了MSM受害者成年后艾滋病高危行为,亦对其心理产生不良影响;亟需加强对有CSA经历的MSM心理健康干预,特别是艾滋病干预.     

医专学生恋爱暴力与童年期虐待经历的关联

目的了解医学专科生恋爱暴力现况及其与不同形式童年期虐待的关联,为医学生恋爱暴力行为的防控提供依据。方法于2019年10-11月采用整群抽样的方法,以安徽省2所医学专科学校3727名有恋爱经历的一、二年级在校生为研究对象,了解一般人口统计学指标、童年期虐待和恋爱暴力等信息,分析不同形式童年期虐待与学生主动和被动恋爱暴力的关联。结果医学生主动恋爱暴力检出率为37.8%,被动恋爱暴力检出率为27.8%。女生童年期情感虐待检出率(61.9%)高于男生(51.6%),男生童年期躯体虐待(28.2%)和性虐待检出率(19.4%)高于女生(24.3%和10.5%)(χ~2值分别为33.84,6.33,52.97,P值均<0.01)。控制相关混杂因素的影响,童年期情感虐待、躯体虐待和性虐待均可能增加大学生恋爱关系中主动暴力[OR值(OR值95%CI)分别为1.71(1.48~1.98)、1.55(1.33~1.82)、1.75(1.43~2.15)]和被动暴力的风险[OR值(OR值95%CI)分别为1.84(1.43~2.16)、1.59(1.34~1.87)、1.62(1.32~2.00)](P值均<0.01)。童年期虐待和主被动恋爱暴力关联的强度性别间差异无统计学意义(P值均>0.05)。结论童年期虐待经历与医学生恋爱暴力的增加有关,减少童年期虐待有益于医学生恋爱暴力行为的防控。     

What’s In an Identity Label? Correlates of Sociodemographics,Psychosocial Characteristics,and Sexual Behavior Among African American Men Who Have Sex With Men

African American men who have sex with men (AAMSM) are vastly overrepresented among people with HIV/AIDS. Using data from 595 AAMSM in Philadelphia, we explored differences in sociodemographics, psychosocial characteristics related to beliefs about ethnicity, sexuality and masculinity, and sexual behavior with men and women by self-reported sexual identity (gay, bisexual, down low, straight). Roughly equivalent numbers identified as gay (40.6 %) and bisexual (41.3 %), while fewer identified as straight (7.6 %) or down low (10.5 %), with significant differences in age, income, history of incarceration, HIV status, alcohol and drug problems, childhood sexual abuse, and connection to the gay community evident among these groups. Analysis of psychosocial characteristics theorized to be related to identity and sexual behavior indicated significant differences in masculinity, homophobia, and outness as MSM. Gay and straight men appeared to be poles on a continuum of frequency of sexual behavior, with bisexual and down low men being sometimes more similar to gay men and sometimes more similar to straight men. The percentage of men having total intercourse of any kind was highest among down low and lowest among gay men. Gay men had less intercourse with women, but more receptive anal intercourse with men than the other identities. There were no significant differences by identity in frequency of condomless insertive anal intercourse with men, but gay men had significantly more condomless receptive anal intercourse. There were significant differences by identity for condomless vaginal and anal intercourse with women. This study demonstrates the importance of exploring differences in types of sex behavior for AAMSM by considering sexual identity.     

广州市男男性行为者儿童期性虐待经历对成年后高危性行为的影响

  目的  了解广州市男男性行为者（men who have sex with men,MSM）的儿童期性虐待（childhood sexual abuse,CSA）情况,分析CSA对成年后高危性行为的影响。  方法  采用非概率抽样方法招募广州市≥ 18周岁的MSM,通过电子问卷收集调查对象的社会人口学资料、CSA经历和近6个月高危性行为情况。采用χ2检验比较不同社会人口学特征的MSM的CSA经历和近6个月的高危性行为情况,用Logistic回归分析模型分析探讨CSA对高危性行为的影响。  结果  调查对象的平均年龄为（28.35±6.83）岁。26.95%（263/976）的MSM遭受过CSA,近6个月多性伴（multiple sexual partners,MSP）率和无保护肛交（unprotected anal intercourse,UAI）率分别为61.68%（602/976）和47.95%（468/976）。调整了年龄、民族、户籍、本地居住时间、婚姻状况、文化程度、工作状况、个人月收入和性取向之后,有CSA者近6个月发生MSP的风险高于无CSA者（aOR=1.62,95% CI:1.19~2.22）,但近6个月UAI与CSA关联的差异无统计学意义。  结论  广州市MSM经历CSA的比例较高,CSA可增加成年后的高危性行为的风险,因此,制定MSM高危性行为干预措施可能需要考虑CSA的影响。     

Child sexual abuse in Henan province,China: associations with sadness,suicidality, and risk behaviors among adolescent girls

PurposeTo assess the prevalence of child sexual abuse (CSA) and possible effects on mental health and risky behavior among female adolescents living in China.MethodA retrospective survey was conducted among 351 female students in a medical secondary school in the central China province of Henan in June 2004. The anonymous, self-administered questionnaire included items about unwanted sexual experiences before age 16, depression, suicidality, and risky health-related behaviors.ResultsOver one in five young women (21.9%) reported at least one type of CSA (any one of 12 forms of nonphysical contact and physical contact CSA) before the age of 16 years, with one in every seven (14.0%) reporting CSA involving physical contact. Risk of CSA was not associated with parents’ education level, existence of siblings, or rural/urban residence during childhood. Although some indicators of poor mental health were slightly elevated among girls who had experienced noncontact CSA only, the most significant impact is among victims of contact CSA, including higher rates of depression, overwhelming sadness, suicidal thinking and planning, alcohol drinking, smoking, fighting, and having sexual intercourse.ConclusionsThe risk of CSA in this sample of Chinese female adolescents seems similar to young women in many Western countries, and the pattern of associated mental health and behavioral problems is entirely consistent with international research.     

Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood

Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.     

Attraction to Sexual Violence Towards Women,Sexual Abuse of Children,and Non-Sexual Criminal Behavior: Testing the Specialist vs. Generalist Models in Male College Students

A sample of 492 college men anonymously completed an expanded version of the Sexual Experiences Survey, the revised Attraction to Sexual Aggression Scale, and the Marlowe-Crowne Social Desirability Scale Short Form to investigate the relations among perpetration of sexual violence (including rape and sexual assault), attraction to sexual violence, attraction to childhood sexual abuse, and attraction towards other crimes while controlling for the impact of social desirability. Analyses indicated that attractions towards sexual violence, general criminality, and childhood sexual abuse were all significantly interrelated. In addition, sexual assault perpetrators reported higher levels of all three types of attraction as compared to nonperpetrators whereas rape perpetrators reported higher levels of attraction to sexual aggression and criminality. Clinical and research implications are discussed.     

Understanding Men’s Self-Reported Sexual Interest in Children

A few studies have found that even in the general population, a minority of adults—men as well as women—report some sexual interest in a young age group. The purpose of the present study was to identify factors associated with self-reported sexual interest in children among a community-based sample of men. Using an online survey methodology, we examined the extent to which different types of childhood adversities (witnessing parental violence, sexual, physical, and emotional abuse), atypical childhood sexual experiences, and participants’ self-reported likelihood of engaging in a variety of sexual behaviors (heightened sexual interest) were related to sexual interest in children (SIC) reported by a non-forensic/non-clinical sample of 173 men. Data were analyzed using hierarchical multiple regression. After controlling for physical and emotional abuse and witnessing parental violence, self-reported experiences of childhood sexual abuse (CSA) significantly increased the amount of variance explained in SIC scores. However, only early masturbation and current heightened sexual interests contributed significantly to the final model. Total variance explained by the model as a whole was 24% (adjusted R² = 20%). Early masturbation and heightened sexual interests significantly mediated the relationship between CSA and SIC scores. Findings add to the small but growing body of literature examining the etiology of pedophilic sexual interests in non-clinical samples.     

Correlates of Increased Sexual Satisfaction

Comparisons of nationally representative survey data of the population ages 18–54 years in 1971 (N = 2252) and 1992 (N = 1718) from Finland show that sexual satisfaction has greatly increased particularly among women. Some predictors of sexual satisfaction of men and women are examined on the basis of the 1992 survey data on people ages 18–74 years (N = 2250). Correlations between social background factors, sexual ideas and assertiveness, optional relationships, sexual practices, orgasm, and satisfaction with sexual intercourse were calculated. To control the simultaneous effect of the variables explaining satisfaction, path analyses were conducted. Results show that young age, a sexually unreserved and a nonreligious childhood home, early start of sexual life, high education, sexual assertiveness, considering sexuality important in life, reciprocal feeling of love, use of sex materials, frequent intercourse, many-sided (versatile) sexual techniques, and frequent orgasm correlate with finding sexual intercourse pleasurable. There were some gender differences in the connections between the independent factors and satisfaction with coitus. The importance of sexuality in life, love, and the use of sexual materials were connected directly to physical sexual satisfaction among men but only indirectly among women. For women, but not for men, young age and early start of sexual life correlated with enjoyment of intercourse. The greater sexual dissatisfaction of women compared to men, which still prevails, may be due to their late start of sexual life, conservative sexual attitudes, unimportance of sexuality in life, lack of sexual assertiveness, and use of restricted sexual techniques. The emancipation of women may change these ideas and practices of women. This might lessen the gender gap in physical sexual satisfaction.     

History of Childhood Sexual Abuse and Unsafe Anal Intercourse in a 6-City Study of HIV-Positive Men Who Have Sex With Men

Objectives. We assessed rates of childhood sexual abuse and its demographic and mental health correlates among HIV-positive men who reported unsafe anal intercourse with other men in the past year.Methods. We conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men enrolled in the Positive Connections intervention.Results. Childhood sexual abuse was reported by 47% of participants; 32% reported frequency as often or sometimes. Men reporting abuse were more likely to be Latino (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.6, 4.2; P < .001) or African American (OR = 1.8; 95% CI = 1.2, 2.7; P = .005) than White. Among those who were abused, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR] = 1.3; P < .001) and unsafe anal intercourse (often, RR = 1.5; sometimes, RR = 2.0; P < .001) compared with men who were not abused.Conclusions. History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color. Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections.Considerable evidence suggests that men who have sex with men (MSM) and who experienced childhood sexual abuse are at heightened risk for HIV infection and sexually transmitted infections (STIs) and associated sexual risk behaviors. Several publications have indicated that self-reported history of sexual abuse is indirectly associated with high-risk sexual behaviors among diverse samples of MSM, such as attendees at targeted events and members of support organizations for lesbian, gay, bisexual, and transgender adolescents.^1–4These reports corroborate earlier studies that found that MSM who reported childhood sexual abuse were at higher risk of becoming HIV positive and engaged in higher rates of unprotected anal intercourse. Few of these studies have focused on whether a history of childhood sexual abuse among HIV-positive MSM is associated with unprotected anal intercourse with partners who are HIV negative.^5–8 In a study of HIV-positive MSM recruited at gay venues in San Francisco and New York City, O''Leary et al. found an association between a history of childhood sexual abuse and unprotected anal intercourse with partners who were HIV negative or of unknown infection status.⁹ With little other research published on the effect of childhood sexual abuse on unsafe sexual behavior among HIV-positive MSM, the generalizability of this report is unknown.Few studies have had an adequate overall sample size to address differences in reported rates of childhood sexual abuse by race/ethnicity with precision. In a study of more than 1000 predominantly HIV-negative MSM, Doll et al. reported higher rates of childhood sexual abuse among African American and Latino than White MSM.¹⁰ Surveillance reports reveal very high rates of diagnosed and undiagnosed HIV infection among MSM of color^11,12; therefore it is critical to identify risk factors that may contribute to higher rates of unsafe sex among racial/ethnic subgroups of HIV-positive MSM.We examined the prevalence of self-reported history of childhood sexual abuse and the demographic and behavioral correlates of such abuse in a group of racially diverse HIV-positive MSM who reported anal intercourse with other men in the past year and who were enrolled in a weekend sexual health intervention to reduce unsafe sexual behavior. We hypothesized that men who reported childhood sexual abuse would also report higher rates of unprotected anal intercourse with men of HIV serodiscordant or unknown HIV infection status.     

Sexual Abuse History,Alcohol Intoxication,and Women’s Sexual Risk Behavior

We examined potential differences in women’s likelihood of sexual risk taking in a laboratory setting based on alcohol intoxication and sexual abuse history. Participants (n = 64) were classified as non-sexually abused (NSA) or as having experienced sexual abuse in childhood only (CSA) or adulthood only (ASA) and randomly assigned to consume alcoholic (.06, .08, or .10% target blood alcohol content) or non-alcoholic drinks, after which participants read and responded to a risky sex vignette. Dependent measures included vaginal pulse amplitude, self-reported sexual arousal, likelihood of engaging in condom use and risky sexual behaviors described in the vignette, and mood. NSA and ASA women did not differ significantly on any dependent measures. CSA women reported significantly lower likelihood of condom use and unprotected intercourse relative to NSA and ASA women. Intoxicated women reported significantly greater sexual arousal, positive mood, and likelihood of risky sex relative to sober women. Intoxicated CSA women reported significantly more likelihood of unprotected oral sex and less likelihood of condom use relative to intoxicated NSA and ASA and sober CSA women. CSA women’s increased risk of sexually transmitted infections (STIs) may be driven by non-condom use and behavioral changes while intoxicated. These findings provide preliminary insight into situational influences affecting CSA women’s increased STI risk.     

Sexual Abuse in Childhood and Sexual Dysfunction in Adulthood: An Australian Population-Based Study

This study examined self-reported adult sexual functioning in individuals reporting a history of childhood sexual abuse (CSA) in a representative sample of the Australian population. A sample of 1793 persons, aged 18–59 years, were randomly selected from the electoral roll for Australian states and territories in April 2000. Respondents were interviewed about their health status and sexual experiences, including unwanted sexual experiences before the age of 16 years. More than one-third of women and approximately one-sixth of men reported a history of CSA. Women were more likely than men to report both non-penetrative and penetrative experiences of CSA. For both sexes, there was a significant association between CSA and symptoms of sexual dysfunction. In assessing the specific nature of the relationship between sexual abuse and sexual dysfunction, statistically significant associations were, in general, evident for women only. CSA was not associated with the level of physical or emotional satisfaction respondents experienced with their sexual activity. The total number of lifetime sexual partners was significantly and positively associated with CSA for females, but not for males; however, the number of sexual partners in the last year was not related to CSA. CSA in the Australian population is common and contributes to significant impairment in the sexual functioning of adults, especially women. These consequences appear not to extend to the other areas of sexual activity considered in this study.     

Relationship Between Childhood Sexual Abuse and HIV-Related Risks Among Men Who Have Sex with Men: Findings from Mainland China

Men who have sex with men (MSM) carry the burden of HIV infection in China. Outside of China, a history of childhood sexual abuse (CSA) has been associated with HIV-related risks (behavioral, sexual, and mental health outcomes) among MSM. We therefore evaluated the relationship between CSA and these HIV-related risks among MSM in China. Cross-sectional data were collected via a survey from gay websites and social networking applications from MSM in 30 provinces in mainland China during a 3-month period in 2014 and 2015. Overall, 999 screened MSM who responded to questions on CSA were included. Multinomial logistic regression models—adjusted for sociodemographic confounders—showed that men who reported experiencing regular CSA and contact CSA, respectively, were more likely to use substances (adjusted odds ratio [AOR], 1.91; 95% confidence interval [CI] 1.39–2.62 and AOR, 1.70; 95% CI 1.25–2.31), had a history of sexually transmitted infections (AOR, 1.81; 95% CI 1.29–2.55 and AOR, 1.65; 95% CI 1.18–2.96), had more male sexual partners (AOR, 1.06; 95% CI 1.04–1.09 and AOR, 1.05; 95% CI 1.03–1.08), engaged in more condomless sex with men (AOR, 1.89; 95% CI 1.39–2.56 and AOR, 1.72; 95% CI 1.29–2.30), and experienced more psychological distress (AOR, 1.05; 95% CI 1.02–1.08 and AOR, 1.05; 95% CI 1.03–1.08). Both frequent and contact forms of CSA were positively associated with HIV-related risks among MSM, suggesting that general CSA prevention strategies and interventions are needed to support this population.     

Sexual health and socioeconomic-related factors in Spain

PurposeThe aim of the present study was to describe sexual health in Spain according to three important indicators of the World Health Organization definition and explore the influence of socioeconomic factors.MethodsWe performed a population-based cross-sectional study of sexually active people aged 16-44 years residing in Spain in 2009 (2365 women and 2532 men). Three main aspects of sexual health were explored: sexual satisfaction, safe sex, and sexual abuse. The independent variables explored were age, age at first intercourse, reason for first intercourse, type of partner, level of education, country of origin, religiousness, parity, and social class. Bivariate and multivariate logistic regression models were fitted.ResultsBoth men and women were quite satisfied with their sexual life, their first sexual intercourse, and their sexual relationships during the previous year. Most participants had practiced safe sex both at first intercourse and during the previous year. Levels of sexual abuse were similar to those in other developed countries. People of disadvantaged socioeconomic position have less satisfying, more unsafe, and more abusive sexual relationships. Women experienced more sexual abuse and had less satisfaction at their first intercourse.ConclusionsThe state of sexual health in Spain is relatively good. However, we observed inequalities according to gender and socioeconomic position.     

Childhood sexual abuse and adult binge drinking among Kanak women in New Caledonia

The long-term consequences of violence against women are poorly documented within the context of political domination, economic inequalities and rapid social change of indigenous communities. Using data from the first population study on violence against women and their consequences on health in New Caledonia, South Pacific, this article investigates the association between childhood sexual abuse and binge drinking among 441 adult Kanak women. Face-to-face standardised interviews were conducted in 2002–2003, among women aged 18–54 years drawn from the electoral rolls. Childhood sexual abuse before 15 years of age was reported by 11.6% of respondents. Nearly all the perpetrators (96%) were known to the victims (63% being a close relative). The rate of frequent binge drinking amongst the women within the last 12 months was 34%. After controlling for social and demographic factors, an independent association was found between childhood sexual abuse and current binge drinking. This study is the first to analyse the contribution of childhood sexual abuse to the likelihood of later heavy alcohol use in an indigenous population in the South Pacific. The findings call for improving and giving priority to care for children who are victims of violence to prevent long-term health consequences and to develop prevention programs aimed at alcohol-related behaviour in women, while taking into account simultaneous individual and collective factors.     

The Effects of Childhood Trauma on Sex Trading in Substance Using Women

This article presents a model developed to understand the relationship between childhood victimization, perpetration of violence, and later cocaine dependence and adult sex trading among drug using women. A cohort of heavy drinking and drug using women (N=594) recruited for two on-going community based HIV prevention studies in St. Louis City was analyzed to evaluate this association using path analysis. The women were stratified into two groups: sex traders and non-sex traders. Sex traders were more likely than non-sex traders to report being forced to kiss or touch someone in a sexual way before age 15 (35% vs. 22%), being kissed or touched in a sexual way by others when they did not want to be (42% vs. 31%), and being forced to have sexual intercourse (30% vs. 21%). Sex traders were more likely than non-sex traders to use a weapon or threaten someone with a weapon (29% vs. 18%) and physically hurt others on purpose before age 15 (9% vs. 5%). Path analysis confirmed that childhood victimization had a significant and direct association with both adult cocaine dependence and sex trading. However, the association between childhood perpetration and adult sex trading was mediated by cocaine dependence. This analysis concludes that childhood victimization was the strongest predictor of cocaine dependence and sex trading in adulthood.     

上海市未婚流产女性青少年儿童期性虐待情况调查

目的了解上海市未婚流产女性青少年的儿童期性虐待(childhood sexual abuse,CSA)发生情况,并探讨儿童期性虐待与健康危险行为和遭受非意愿性行为的关系。方法采用现况调查的方法,应用计算机辅助自填问卷技术匿名调查24岁及以下的未婚流产女性的儿童期性虐待及可能的健康危害情况。结果 16.69%的未婚流产女性报告在14岁前至少经历过1种形式的CSA,其中50.34%的受害者曾遭受过1种形式的性虐待,18.79%遭受过2种形式的CSA,遭受过3种及以上形式的占30.87%;最常见的儿童期性虐待形式是施虐者在受害者面前暴露生殖器(7.61%),其次是被抚摸乳房或生殖器(5.82%);施虐者主要是同学/朋友和陌生人。与未遭受过儿童期性虐待者相比,有儿童期性虐待经历的女性在以后发生健康危险行为和遭受非意愿性行为侵扰的比例明显偏高(P<0.05)。结论未婚流产女性青少年儿童期性虐待问题较为常见,且与以后的健康危险行为和非意愿性行为密切相关;应采取有效措施预防儿童期性虐待的发生,减少其危害。