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The Impact of Traumatic Experiences on Risky Sexual Behaviors in Black and White Young Adult Women
Authors:Kimberly B. Werner  Renee M. Cunningham-Williams  Whitney Sewell  Arpana Agrawal  Vivia V. McCutcheon  Mary Waldron  Andrew C. Heath  Kathleen K. Bucholz
Affiliation:1. Missouri Institute of Mental Health, University of Missouri, St. Louis, Missouri;2. George Warren Brown School of Social Work, Washington University, St. Louis, Missouri;3. Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri;4. Department of Counseling and Educational Psychology, Indiana University School of Education, Bloomington, Indiana
Abstract:

Background

Trauma exposure has been linked to risky sexual behavior (RSB), but few studies have examined the impact of distinct trauma types on RSB in one model or how the association with trauma and RSB may differ across race.

Purpose

The objective of the current study was to examine the contribution of trauma exposure types to RSB—substance-related RSB and partner-related RSB identified through factor analysis—in young Black and White adult women.

Methods

We investigated the associations of multiple trauma types and RSB factor scores in participants from a general population sample of young adult female twins (n = 2,948). We examined the independent relationship between specific traumas and RSB, adjusting for substance use, psychopathology, and familial covariates. All pertinent constructs were coded positive only if they occurred before sexual debut.

Results

In Black women, sexual abuse was significantly associated with substance-related and partner-related RSB, but retained significance only for partner-related RSB in a fully adjusted model. For White women, sexual abuse and physical abuse were associated with both RSB factors in the base and fully adjusted models. Witnessing injury or death was only associated with RSBs in base models. For both groups, initiating alcohol (for Black women), alcohol, or cannabis (for White women) before sexual debut (i.e., early exposure) was associated with the greatest increased odds of RSB.

Conclusions

Data highlight the contribution of prior sexual abuse to RSBs for both White and Black women, and of prior physical abuse to RSBs for White women. Findings have implications for intervention after physical and sexual abuse exposure to prevent RSB, and thus, potentially reduce sexually transmitted infection/human immunodeficiency virus infection and unintended pregnancy in young women.
Keywords:Correspondence to: Kimberly B. Werner, PhD, Missouri Institute of Mental Health, University of Missouri – St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134   Phone: 314-516-8421.
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