Violence and its relationship to substance use in adolescent pregnancy.

We surveyed 342 pregnant adolescents 17 years old and younger for a history of physical or sexual assault and substance use to investigate whether victims of childhood violence are at increased risk of smoking and using alcohol or drugs. A total of 95% of new patients who attended the university's teen pregnancy clinic between May 8, 1989, and December 8, 1990, were interviewed. Substance use was reported seven times more often in those with a history of combined physical and sexual assault, five times more frequently by those who had been sexually assaulted, and three times more often in those who had been physically assaulted than adolescents without a history of assault. Violence was associated with substance use in all ethnic groups although this relationship was modified by ethnicity. Among Hispanics, an association was observed between physical assault and tobacco use. Sexual and combined physical and sexual assault were strongly associated with use of alcohol among blacks. All categories of violence were associated with drug use among all ethnic groups. When use of each substance was analyzed by the adolescent's relationship to the perpetrator, drug use was most strongly associated with assault by a mate, whereas tobacco or alcohol use was more often associated with assault by a member of the victim's family of origin.     

EDITORIAL

We investigated the effects of physical, psychological, and sexual violence on the health status of women attending antenatal clinics at two tertiary hospitals in rural Thailand. We asked 421 pregnant women at 32 weeks gestation or later to complete a survey questionnaire. Participants reported high rates of psychological abuse (53.7%); threats, acts of physical abuse, or both (26.6%); and sexual violence (19.2%). Women abused during pregnancy had poorer health compared with nonabused women, in role emotional functioning, vitality, bodily pain, mental health, and social functioning. Given the high prevalence of violence and poor health status, routine screenings by maternity services is urgently required.     

Associations between interpersonal violence victimisation and concussions among US college students

Interpersonal violence is common on college campuses and is associated with many adverse health outcomes; however, it remains unknown whether experiencing interpersonal violence victimisation is associated with concussions. The aim of this study was to estimate the associations between interpersonal violence, including emotional abuse, physical abuse and sexual assault, and concussions among a large, diverse sample of college students. We analysed cross-sectional data from the 2018–2019 national (US) Healthy Minds Study (N = 1,478). Multiple logistic regression analyses were conducted to estimate the association between interpersonal violence victimisation (any violence victimisation, emotional abuse, physical abuse and sexual assault) and concussion history (any concussion, diagnosed concussion and undiagnosed concussion), while adjusting for potential confounders. Analyses were conducted among the overall sample and separately by male and female participants. Results showed patterns of significant associations between interpersonal violence victimisation and concussions among the overall sample and among male and female participants. Among the overall sample, any interpersonal violence victimisation (adjusted odds ratio [AOR] 1.45, 95% confidence interval [CI] 1.13–1.88), emotional abuse (AOR 1.36, 95% CI 1.06–1.76), physical abuse (AOR 1.61, 95% CI 1.07–2.44) and sexual assault (AOR 2.17, 95% CI 1.44–3.26) were associated with higher odds of any concussion history. Sexual assault victimisation had the strongest association with any concussion history among male (AOR 1.96, 95% CI 1.04–3.71) and female (AOR 2.96, 95% CI 1.62–5.43) participants. These results expand on prior interpersonal violence and concussion research by showing an association with multiple victimisation measures among a large and diverse sample of college students. Medical professionals should screen for concussions among college students who experience emotional abuse, physical abuse and sexual assault to provide appropriate guidance. Information on the symptoms of concussions should be incorporated into campus violence awareness and prevention efforts.     

Battering during pregnancy: tip of an iceberg revealed

Physical abuse of women is pervasive with one in three women experiencing battering. Battering occurs during pregnancy with women reporting blows to the pregnant abdomen, injuries to the breast and genitals, and sexual assault. A recent study in a large metropolitan area documented one in twelve pregnant women to have been physically battered during the present pregnancy. Among the women battered, 87% had been physically abused prior to pregnancy and 29% reported the abuse increased after becoming pregnant. Health care providers did not assess any of the women for abuse. When pregnancy outcome was analyzed in another study of 589 postpartum women, battered women were four times more likely to deliver a low-birthweight infant. This paper discusses the etiology of battering, prevalence of battering during pregnancy and pregnancy outcomes of battered women. A community-wide primary prevention program is presented that has linked the health care provider with law enforcement and shelters for battered women to interrupt the cycle of violence and promote the health and safety of pregnant women.     

Violence against women in Mexico: a study of abuse before and during pregnancy

OBJECTIVE: We identified the prevalence and types of violence experienced by pregnant women, the ways victimization changed during pregnancy from the year prior to pregnancy, and factors associated with violence during pregnancy. METHODS: We interviewed 914 pregnant women treated in health clinics in Mexico about violence during and prior to pregnancy, violence during childhood and against their own children, and other socioeconomic indicators. RESULTS: Approximately one quarter of the women experienced violence during pregnancy. The severity of emotional violence increased during pregnancy, whereas physical and sexual violence decreased. The strongest predictors of abuse were violence prior to pregnancy, low socioeconomic status, parental violence witnessed by women in childhood, and violence in the abusive partner's childhood. The probability of violence during pregnancy for women experiencing all of these factors was 61%. CONCLUSIONS: Violence is common among pregnant women, but pregnancy does not appear to be an initiating factor. Intergenerational violence is highly predictive of violence during pregnancy.     

Prevalence of battering among 1780 outpatients at an internal medicine institution in Mexico

Violence against women has recently drawn attention in the medical community as a leading cause of preventable morbidity and mortality. Specific algorithms designed to identify women at risk can be applied to create an opportunity for screening, diagnosis and treatment during medical care initiated for common conditions. This study investigated the incidence and history of battering among women seeking general medical care, and looked for potential risk factors and associations with presenting symptoms. We used a self-administered, anonymous survey to question 1780 adult female outpatients visiting a tertiary care internal medicine teaching hospital in Mexico City. We calculated current abuse (physical and/or sexual abuse by a partner within the past year), abuse during pregnancy, childhood abuse, and lifetime abuse. We found levels of violence against women in Mexico comparable to those reported from other countries. 152 women (9%) reported current physical and/or sexual abuse. An identical number also reported abuse during pregnancy. Lifetime prevalence was 41%. Women currently or previously abused reported more physical symptoms in the last six months than did non-abused participants. Pelvic pain, depression, headache and substance abuse were frequent among abused women. Currently abused women also scored higher (p<0.01) on indicators of depression. Current abuse correlated strongly with a childhood history of physical and/or sexual abuse, with low educational level of the victim, with substance abuse by the partner or by the woman herself, and with higher parity.     

Battering During Pregnancy:

Physical abuse of women is pervasive with one in three women experiencing battering. Battering occurs during pregnancy with women reporting blows to the pregnant abdomen, injuries to the breast and genitals, and sexual assault. A recent study in a large metropolitan area documented one in twelve pregnant women to have been physically battered during the present regnany. Among the women battered, 87% had been physically abused prior to pregnancy and 29% reported the abuse increased after becoming pregnant. Health care providers did not assess any of the women for abuse. When pregnancy outcome was analyzed in another study of 589 postpartum women, battered women were four times more likely to deliver a low-birthweight infant. This paper discusses the etiology of battering, prevalence of battering during pregnancy and pregnancy outcomes of battered women. A community-wide primary prevention program is presented that has linked the health care provider with law enforcement and shelters for battered women to interrupt the cycle of violence and promote the health and safety of pregnant women.     

Physical and sexual abuse as predictors of substance use and suicide among pregnant teenagers.

In order to better define risk factors for perinatal substance abuse, data from 352 pregnant teenagers enrolled in a comprehensive prenatal clinic were analyzed. Fifteen years was the average age, 82% were of minority descent, and all were receiving public assistance. At their first visit, a social worker obtained information on their home environment, family history, education, peer relationships, physical and mental health, and history of substance use. Following the interview, all teens were given a complete prenatal examination, including drug toxicology screening. The results indicate relatively low rates of substance use based on toxicology at the time of enrollment (3.6%). Self-reported rates of substance use prior to awareness of conception varied from 23% for tobacco to 17% for alcohol and marijuana; 7% of the subjects reported use of illicit substances after conception was confirmed. In addition, 80 of the 352 subjects acknowledged having been physically or sexually abused and 40 admitted to having suicidal ideation or actions. A comparison of those teenagers who had been physically or sexually abused with the remaining cohort revealed significant differences on marijuana (p less than 0.01) and cocaine (p less than 0.05) use prior to awareness of conception and on prior suicidality (p less than 0.0001). A positive history of physical or sexual abuse delineated a subset of pregnant teenagers who were at high risk for self-destructive behaviors. Teenagers in prenatal clinics should be screened, not only for current and past substance use, but also for sexual and physical abuse, domestic violence, and suicidal thoughts and actions.     

童年期被虐待经历对大学生恋爱暴力发生的影响

目的 了解大学生恋爱暴力的发生情况及童年期被虐待经历对大学生恋爱暴力发生的影响。方法 采用滚雪球抽样的方法,对北京市7所大学的1 130名大学生进行不记名自填式问卷调查。结果 1 130名大学生中50.8%最近一年有过恋爱经历,其中遭受和实施恋爱暴力的比例分别为16.9%和11.1%。遭受肢体暴力、情感虐待和性暴力的比例分别为14.1%、10.6%和9.9%,实施肢体暴力、情感虐待和性暴力的比例分别为8.0%、7.1%和3.7%。有509名(45.0%)大学生在童年期曾有被父母虐待的经历,其中被用力徒手打、用物品打、在其他人面前遭到羞辱和目睹父母打架或父母打兄弟姐妹的比例分别为41.6%、24.9%、13.1%和24.5%。具有童年期被虐待经历的大学生遭受和实施恋爱暴力的比例均高于童年期没有被虐待经历的大学生,差异具有统计学意义(P=0.005)。结论 大学生恋爱暴力问题不容忽视,童年期遭受父母虐待经历对大学生恋爱暴力的发生具有一定影响。     

Prevalence and severity of domestic violence among pregnant women, Mexico

OBJECTIVES: To determine whether pregnancy is a risk factor for domestic violence and to compare prevalence and severity of violence reported by women before and during pregnancy. METHODS: There were interviewed 468 women in the third trimester of pregnancy who were seen during prenatal visits at public clinics in the state of Morelos, Mexico. Emotional, physical and sexual violence were investigated. A severity index was built up. Logistic regression analysis was applied in order to identify the main variables associated to domestic violence during pregnancy. RESULTS: The prevalence of domestic violence did not change significantly before and during pregnancy (32%). The prevalence of each type of violence remained the same. About 27% of women who reported violence during pregnancy did not have experience it before, and a comparable proportion had experienced violence before but not during pregnancy. The severity of emotional violence significantly increased during pregnancy (compared to the previous year) whereas the severity of physical violence decreased. Variables most clearly related to violence during pregnancy were: couple's past history of child abuse; women witnessing domestic violence during childhood; and violence in the year before pregnancy. Several risk scenarios were identified, which could be helpful for health care providers. CONCLUSIONS: The results showed that emotional violence is more prevalent than physical and sexual violence, allowing for a better understanding of this phenomenon.     

Teenage pregnancy and associated risk behaviors among sexually abused adolescents

CONTEXT: Previous research suggests a link between adolescent pregnancy and sexual abuse history, but most studies have used clinical samples of females only and single measures of abuse. METHODS: Associations between pregnancy involvement, risk behaviors and sexual abuse were examined in sexually experienced teenagers from the Minnesota Student Surveys of 1992 (N=29,187) and 1998 (N=25,002). Chi-square tests assessed differences in pregnancy involvement and related risk behaviors among four groups of adolescents, categorized by type of abuse experienced: none, incest only, nonfamilial only or both. Odds ratios for pregnancy involvement and risk behaviors, adjusted for grade level and race, were calculated for each gender by using logistic regression analysis. RESULTS: Sexual abuse was reported by 6% of males and 27% of females in 1992, and by 9% and 22% in 1998. Reports of pregnancy involvement were significantly more common among abused adolescents (13-26% of females and 22-61% of males, depending on type of abuse) than among nonabused adolescents (8-10%). Abused adolescents were more likely than others to report risk behaviors, and teenagers reporting both abuse types had the highest odds of pregnancy involvement and risk behaviors. The differential in the odds of pregnancy involvement and most behaviors was larger between nonabused and abused males than between nonabused and abused females. CONCLUSIONS: Teenage pregnancy risk is strongly linked to sexual abuse, especially for males and those who have experienced both incest and nonfamilial abuse. To further reduce the U.S. teenage pregnancy rate, the pregnancy prevention needs of these groups must be adequately addressed.     

Partner violence against pregnant women in Mexico City

OBJECTIVE: To assess factors related to partner violence against pregnant women. METHODS: Data were collected from 383 pregnant women eligible attending five family medicine units of the Mexican institute of social security in Mexico City, Mexico, between September 2003 and August 2004. Data collection was carried out using a questionnaire developed for the study. RESULTS: Of all women interviewed, 120 (31.1%) reported that they had been exposed to psychological and/or physical and/or sexual violence perpetrated by their partners during the current pregnancy; 10% reported combined violence and 21% isolated violence. Psychological violence was most frequently reported (in 93% of the "experienced violence" group). As for their perception of violence there was not found any significant differences between those women who had experienced versus those who did not experience violence. Only about 20% of women had knowledge of centers for women victims of violence. The factors significantly associated with partner violence among pregnant women included: being single (OR=3.02; 95% CI: 1.17;7.83), being unmarried and living with a partner (OR=2.22; 95% CI: 1.11;4.42), history of violence during childhood (OR= 3.08; 95% CI: 1.62;5.85), alcohol consumption by the partner (OR=1.87; 95% CI: 1.02;3.42) and emotional distress among women (OR=4.17; 95% CI: 1.12;15.51). CONCLUSIONS: The study results stress other research findings that violence against pregnant Mexican women is still common.     

2575名在校大学生亲密伴侣暴力现况研究

目的 了解大学生恋爱中的性行为和亲密伴侣暴力行为情况,探讨亲密伴侣暴力与大学生其他部分心理行为的关系.方法 采取整群抽样的方法,对合肥和芜湖市3所高校2575名在校大学生进行问卷调查,内容包括恋爱情况、遭受亲密伴侣暴力情况、抑郁症状、自尊、学校生活满意度和自杀相关心理行为.x2检验和方差分析探讨不同恋爱经历大学生心理行为状况的差异.结果 2575名大学生中46.9%有过恋爱经历;男生高于女生,大二、三年级学生高于大一年级学生(x2值分别为44.13、161.84,P值均<0.05).目前正在恋爱的大学生中21.1%报告与现在的恋人发生过性行为,其中仅有21.8%(34/156)每次都使用安全套,11.5%(18/156)从不采用任何避孕措施,18.6%(29/156)与现在恋人(女友)发生性行为而怀孕,孕后到正规医院进行处理的比例仅占48.3%(14/29).有过恋爱经历的大学生中,遭受躯体暴力、心理暴力、性暴力、总暴力的报告率分别为18.0%、33.6%、5.1%、37.1%;男生遭受躯体暴力、心理暴力、总暴力的比例均高于女生,女生遭受性暴力的比例高于男生(x2值分别为70.21、13.25、14.04、5.77,P值均<0.05).在遭受过亲密伴侣暴力的大学生中,有74.2%(345/446)经历过3次以上亲密伴侣暴力.经历过亲密伴侣暴力的大学生抑郁症状得分最高,自尊和学校生活满意度得分最低(F值分别为4.00、16.39和8.76,P值均<0.05),自杀意念、自杀计划、自杀准备、自杀未遂的报告率均最高(x2值分别为13.80、9.72、8.52、11.96,P值均<0.05).结论 大学生恋人间性行为发生率较高,且保护意识缺乏;大学生亲密伴侣暴力现象较常见,且与其他不良心理行为关系密切.

Abstract：

Objective To investigate the prevalence of love affairs and intimate partner violence,and to explore the relationship between intimate partner violence and other mental health and risk behavior in college students.Methods Three universities were selected using cluster sampling method in Hefei and Wuhu.Totally.2575 college students completed an anonymous questionnaire.Intimate partner violence,depression,satisfaction of school life,self-esteem,suicidal psychology and behavior were evaluated to estimate the relationship between intimate partner violence and mental health/risk behavior.Results There were 46.9%students reported that they had intimate partner currently or in the past.The rate of having intimate partner in male students was higher than that in female students(x2=44.13,P<0.001).And the rates were higher in sophomores and juniors than in freshmen(x2=161.84,P<0.05).There were 21.1% students had sexual behavior with their intimate partners.But only 21.8%(34/156)intimate partners reported that they used condom every time.There were 11.5%(18/156)intimate partners reported that they never took any contraception.There were 18.6%(29/156)students reported that they were pregnant or led to their girlfriend becoming pregnant,but only less than 50.0% adolescents induced abortion in a legal hospitals.The rates of being the victim of physical assault,emotional abuse,sexual coercion,the total intimate partner violence were 18.0%,33.6%,5.1%.37.1%.The rates of being the victim of physical assault,emotional abuse,total intimate partner violence in male adolescents were higher than those in female adolescents,but the rate of sexual coercion was on the contrary(x2=70.21,13.25,14.04,5.77,P<0.05).Among the intimate partners who had suffered from intimate partner,74.2%(345/446)students had underwent more than 3 times.and 47.1% had underwent more than 2 types of intimate partner violence.The score of depression was highest in the victims of intimate partner violence,but the scores of self-esteem and school life satisfaction were on the contrary(F=4.00,16.39,8.76,P<0.05).The rates of suicidal ideation,suicidal plan,suicidal preparative and attempted suicide were highest in the victims of intimate partner violence(x2=13.80,9.72,8.52,11.96,P<0.05).Conclusion The rate of having sexual behavior with their intimate partners was high in college students,but their self-protection awareness was insufficient.In the present study,a high prevalence of intimate partner violence among university students was observed,and highlighted a need for attention to the other mental health and risk behavior in adolescents with intimate partner violence.     

Childhood Abuse as a Risk Factor for Adolescent Pregnancy in El Salvador

PURPOSE: To determine whether having been abused as a child increases the risk of adolescent pregnancy in El Salvador and whether intimate partner violence during adolescence affects the association. METHODS: Using data from 3753 women between the ages of 15 and 24 from a nationally representative household health survey of Salvadoran women (FESAL 2002/2003), the association between history of childhood abuse (emotional, physical, or sexual abuse, and witnessing abuse of one's mother) and adolescent pregnancy was explored using multiple logistic regression analyses. The effect of intimate partner violence during adolescence on the relationship was explored among a subgroup of 15-19-year-olds. RESULTS: The risk of adolescent pregnancy was significantly higher among women abused as children. Women who were sexually abused, physically abused, or who experienced any type of abuse had a 48%, 42%, and 31% higher risk, respectively, of adolescent pregnancy than those without a history of abuse, after adjusting for confounding factors. Intimate partner violence during adolescence was also strongly and significantly linked with adolescent pregnancy risk. CONCLUSIONS: This is the first study from a Latin American country to demonstrate a relationship between childhood abuse and adolescent pregnancy. Greater efforts are needed to promote detection of abuse, expand knowledge about sexual and reproductive health, protect vulnerable youth, and to advocate for greater rights and social protections to Salvadoran children and adolescents.     

Sexual Victimization and Somatic Complaints in Pregnancy: Examination of Depression as a Mediator

PurposeResearch suggests that women with histories of sexual victimization are more likely to experience somatic complaints in pregnancy. However, prior studies have been limited by homogenous samples, have primarily only examined the relationship of childhood sexual abuse (CSA) to somatic complaints, and have not examined potential mechanisms explaining this association. Thus, the current study examined the relationship between lifetime sexual victimization history and somatic complaints in pregnancy in an ethnically diverse sample of pregnant women. Additionally, depressive symptoms were examined as a mediator of the sexual victimization–somatic complaints relationship.ProceduresWomen were recruited from the waiting room of a university-affiliated obstetrics–gynecology clinic to complete a study of psychological health and negative sexual experiences. The 407 currently pregnant participants who completed measures of their sexual victimization history, depressive symptoms, and somatic complaints were primarily African American (53.6%), low to middle income (75.4%), and reported an unplanned pregnancy (72%).FindingsA total of 27.7% of women had a history of CSA and/or adolescent/adult sexual assault. Mediation analyses using bootstrapping supported depression as a significant mediator of the relationship between sexual victimization and somatic complaints, with a medium-sized effect (κ² = .09).ConclusionsHaving a history of sexual victimization is associated with risk for poor mental and physical health during pregnancy. There are likely multiple mechanisms explaining the association between sexual victimization and somatic complaints in pregnancy, which should be investigated in future research.     

Violence and social representation in teenagers in Brazil]

OBJECTIVE: To investigate the association between the self-representation of teenagers and the severe physical, psychological, and sexual violence inflicted on them by close family relations, especially their parents, and to analyze the association between victimization in the family and victimization in other social spaces. METHOD: An epidemiological survey was carried out in 2002 with 1 685 adolescents chosen at random from public and private schools in the municipality of S?o Gon?alo, which is in the state of Rio de Janeiro, Brazil. To measure each form of violence, we used scales of tactics for dealing with conflict, of child abuse and trauma, and of psychological violence. RESULTS: We found that 14.6% of the students had been physically abused by the father or the mother and that 11.8% had witnessed sexual abuse of another family member or they themselves had been sexually abused. In addition, 48.0% of the students reported having been psychologically abused by a close relation. In comparison to students who had not been abused, the victims of family abuse were more often also victims of community and school violence, and they also more frequently reported having broken the law. Overall, the adolescents surveyed had a positive self-representation, but the adolescents who had been abused mentioned negative self-attributes more frequently than did the teenagers who had not been abused. CONCLUSIONS: The predominantly positive social representation of teenagers must be supported by health promotion initiatives. The finding of an association between indices of violence and the teenager's various spheres of action indicates that resolving this problem will require strategies that target all these spheres.     

Prevalence and Associated Factors of Intimate Partner Violence Among Pregnant Women Attending Kisumu District Hospital, Kenya

To determine prevalence and factors associated with intimate partner violence (IPV) among pregnant women seeking antenatal care. This was a cross-sectional study conducted at Kisumu District Hospital, Kenya amongst randomly selected pregnant women. A structured questionnaire was used to collect data. Participants self-reported about their own IPV experience (lifetime, 12 months prior to and during index pregnancy) and associated risk factors. Data were analyzed using Epi-info. The mean age of the 300 participants was 23.7 years. One hundred and ten (37 %) of them experienced at least one form of IPV during pregnancy. Psychological violence was the most common (29 %), followed by sexual (12 %), and then physical (10 %). Women who experienced IPV during pregnancy were more likely to have witnessed maternal abuse in childhood (aOR 2.27, 95 % CI = 1.05–4.89), been in a polygamous union (aOR 2.48, 95 % CI = 1.06–5.8), been multiparous (aOR 1.94, 95 % CI = 1.01–3.32) or had a partner who drank alcohol (aOR 2.32, 95 % CI = 1.21–4.45). Having a partner who attained tertiary education was protective against IPV (aOR 0.37, 95 % CI = 0.16–0.83). We found no association between HIV status and IPV. IPV is common among women seeking antenatal care at Kisumu District Hospital. Health care providers should be alerted to the possibility of IPV during pregnancy in women who witnessed maternal abuse in childhood, are multiparous, polygamous, have a partner who drinks alcohol or has low level education. Screening for IPV, support and referral is urgently needed to help reduce the burden experienced by pregnant women and their unborn babies.     

Physical, emotional and sexual violence during pregnancy in Malatya, Turkey

BACKGROUND: In Turkey, violence against women was established as a critical area of concern related to women and various prevention strategies have been developed since 1980. There are limited numbers of studies on violence during pregnancy in the country. This study was performed to determine the prevalence of physical, emotional and sexual violence during pregnancy in Malatya province and the associated factors. METHODS: A cross-sectional interview survey was conducted among pregnant women living in Malatya province between October 2003 and May 2004. Stratified probability-proportional-to-size sampling methodology was used for selecting the study population. A total of 824 pregnant women from 60 clusters were studied. Association between violence prevalences and womens' sociodemographic, fertility and behavioural characteristics were evaluated. RESULTS: During pregnancy 31.7% of women were exposed to any form of violence. Emotional violence was the most frequently reported form (26.7%), followed by sexual (9.7%) and physical violence (8.1%). Regular smoking [odds ratio (OR) 1.6], unwanted pregnancy (OR 1.8), living in urban area (OR 1.5), low education level of husband (OR 1.7), low family income (OR 1.9) and being in second trimester (OR 1.4) were determined to be the main predictors of overall violence during pregnancy. CONCLUSIONS: Violence during pregnancy is a common public health problem in Malatya. Low education level in partners, low family income, husband's unemployment, urban settlement, unwanted pregnancy and smoking should alert health staff towards violence at pregnancy and training of health personnel on the subject is recommended.     

Sexual intercourse, abuse and pregnancy among adolescent women: does sexual orientation make a difference?

CONTEXT: Although a limited amount of research has retrospectively explored the childhood and adolescent heterosexual experiences of lesbians, little is known about the prevalence of heterosexual behavior and related risk factors or about pregnancy histories among lesbian and bisexual teenagers. METHODS: A secondary analysis was conducted using responses from a subsample of 3,816 students who completed the 1987 Minnesota Adolescent Health Survey. Behaviors, risk factors and pregnancy histories were compared among adolescents who identified themselves as lesbian or bisexual, as unsure of their sexual orientation and as heterosexual. RESULTS: Overall, bisexual or lesbian respondents were about as likely as heterosexual women ever to have had intercourse (33% and 29%, respectively), but they had a significantly higher prevalence of pregnancy (12%) and physical or sexual abuse (19-22%) than heterosexual or unsure adolescents. Among sexually experienced respondents, bisexual or lesbian and heterosexual women reported greater use of ineffective contraceptives (12-15% of those who used a method) than unsure adolescents (9%); bisexual or lesbian respondents were the most likely to have frequent intercourse (22%, compared with 15-17% of the other groups). In the sample overall, among those who were sexually experienced and among those who had ever been pregnant, bisexual or lesbian women were the most likely to have engaged in prostitution during the previous year. CONCLUSIONS: Providers of reproductive health care and family planning services should not assume that pregnant teenagers are heterosexual or that adolescents who say they are bisexual, lesbian or unsure of their sexual orientation are not in need of family planning counseling. Further research should explore the interactions between adolescent sexual identity development and sexual risk behaviors.