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1.
OBJECTIVE: The prevalence and characteristics of childhood sexual abuse (CSA) among men who have sex with men (MSM), and links with sexual risk are explored. A model linking CSA and sexual risk among MSM is proposed. METHOD: A telephone probability sample of urban MSM (n = 2881) was recruited and interviewed between November 1996 and February 1998. The interview covered numerous health issues, including history of sexual victimization. RESULTS: One-fifth reported CSA, primarily by non-family perpetrators. Initial CSA experiences are characterized by high levels of force (43% involved physical force/weapons), and penetrative sex (78%; 46% reported attempted or actual anal intercourse). Such men are more likely than nevercoerced men to engage in high risk sex (unprotected anal intercourse with a non-primary partner or with a serodiscordant male). In multivariate analyses, the effect of childhood sexual coercion on sexual risk is mediated by substance use, patterns of sexual contacts, and partner violence, but not by adult sexual revictimization or by depression. CONCLUSIONS: Findings are interpreted within the context of social learning theory and prior research on sexual risk-taking. The high risk for CSA among MSM, which can predispose such men to patterns of HIV sexual risk, warrants new approaches in HIV prevention. 相似文献
2.
Objective
Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as having experienced CSA despite meeting objective criteria that CSA occurred. This study sought to determine whether individuals who met research criteria for CSA and who self-defined as sexually abused differed on traumagenic dynamics constructs and current sexual risk behavior from individuals who met research criteria for CSA and who did not self-define as sexually abused.Methods
Participants were 481 women recruited from a publicly funded STD clinic. Participants completed a computerized survey assessing childhood sexual experiences and adult sexual risk behavior.Results
Of the total sample, 206 (43%) met research criteria for CSA. Of the women meeting research criteria for CSA, 142 (69%) self-defined as sexually abused. Women who met research criteria for CSA reported more traumatic sexualization, more trust of a partner, more powerlessness, less sexual guilt, more episodes of unprotected sex, more sex partners, and greater likelihood of sex trading, compared to women who did not meet research criteria for CSA. Among women meeting research criteria, those who self-defined as sexually abused did not differ from those who did not self-define on any of the traumagenic dynamics constructs or on current sexual risk behavior, controlling for CSA characteristics.Conclusions
Individuals who were sexually abused as children by behavioral research criteria are at risk for engaging in sexual risk behavior as adults, regardless of whether or not they perceive the experience to be CSA. Future research is needed to understand how non-definers perceive these childhood sexual experiences. 相似文献3.
BackgroundChildhood sexual abuse (CSA) is a serious public health problem worldwide.ObjectivesWe reported the prevalence of CSA and examined its association with risky sexual behaviors and adverse reproductive health outcomes among college students in China.Participants and settingParticipants were 17,966 college students from 130 colleges in Eastern, Central, and Western China, who completed the online questionnaire in January–August 2015.MethodsData were obtained from a cluster-random Internet-based survey. Multivariate logistic regression analyses were employed: risky sexual behaviors and adverse reproductive health outcomes were outcome variables, and various types of CSA were predictor variables, while adjusting for socio-demographic and lifestyle characteristics.ResultsThe overall prevalence of any type of CSA was 27.5%. Most perpetrators were friends/acquaintances (34.6%) or intimate partners (24.7%) of the victims. Respondents who reported penetrative CSA were strongly associated with regular unprotected sex (odds ratio (OR): 3.0, 95% confidence interval (CI): 2.2–4.0), early sexual debut (OR: 5.5, 95% CI: 3.3–9.1), having genital tract symptoms in the last 12 months (OR: 5.0, 95% CI: 4.1–6.0), unintended pregnancy (OR: 6.2, 95% CI: 4.2–9.0), and induced abortion (OR: 5.5, 95% CI: 3.7–8.2) (for boys, the survey asked about history of unintended pregnancy and induced abortion of their sexual partners). A dose-response relationship was found across non-contact, contact, and penetrative CSA.ConclusionsCSA experience may increase the likelihood of risky sexual behaviors and adverse reproductive health outcomes in victims’ early adulthood. 相似文献
4.
Structural equation modeling (SEM) techniques were used to compare 5 methods of assessing HIV/AIDS sexual risk in a large prediction model. These were: (a) multiple measures; (b) a single latent factor; (c) modifying the computation of the dependent variables used in Methods 1 and 2 to weight sexual encounters by specific partner risk; (d) use of risk composites, obtained by multiplying number of sexual partners by number of occasions of unprotected sex; and (e) use of risk indexes that assign a number based on responses to general questions about risk behaviors. Data from 452 at‐risk women from a New England community were analyzed in 5 versions of an HIV/AIDS sexual risk prediction model. Models were compared in terms of SEM empirical fit indexes (x2 [df], average absolute standardized residuals, and Comparative Fit Index); significant paths, explained variance, theoretical fit, and simplicity. Results indicate that: (a) multiple measures and latent factor models are preferable to all others by each of the standards of comparison, (b) in the composite dependent variable models, including information about the partners' number of partners provided little additional explained variance beyond knowing the number of occasions of unprotected sex, and (c) dependent measures that did not remain close to Centers for Disease Control criteria may not be adequately predicting HIV/AIDS sexual risk. Several recommendations are presented for selecting an appropriate conceptualization of HIV/AIDS sexual risk. 相似文献
5.
Many adolescents are susceptible to negative outcomes associated with sexual behavior. This is particularly true for those who initiate sexual intercourse at an early age, have many sex partners, or engage in unprotected sex because these behaviors put one at risk for sexually transmitted infections (STIs), including HIV. This article reviews the various demographic, social‐contextual, and intrapersonal factors linked to sexual risk behaviors. Successful STI/HIV prevention programs must consider developmental and gender issues, as well as cultural norms and values, to effectively meet the prevention needs of all adolescents. We discuss the characteristics of effective intervention programs and provide the names and key features of empirically validated, school‐based STI/HIV prevention programs. In addition, we recommend specific roles for school psychologists in STI/HIV prevention efforts. Finally, other resources are provided to assist practitioners in their continuing review of STI/HIV prevention education. © 2007 Wiley Periodicals, Inc. 相似文献
6.
Larry D. Icard John B. Jemmott III Anne Teitelman Ann O’Leary G. Anita Heeren 《Child abuse & neglect》2014
HIV/AIDS prevalence in South Africa is one of the highest in the world with heterosexual, transmission predominantly promoting the epidemic. The goal of this study is to examine whether, marijuana use and problem drinking mediate the relationship between histories of childhood sexual, abuse (CSA) and HIV risk behaviors among heterosexual men. Participants were 1181 Black men aged, 18–45 from randomly selected neighborhoods in Eastern Cape Province, South Africa. Audio computer assisted, self-interviewing was used to assess self-reported childhood sexual abuse, problem drinking, and marijuana (dagga) use, and HIV sexual transmission behavior with steady and casual partners. Data were analyzed using multiple meditational modeling. There was more support for problem, drinking than marijuana use as a mediator. Findings suggest that problem drinking and marijuana use, mediate HIV sexual risk behaviors in men with histories of CSA. Focusing on men with histories of CSA, and their use of marijuana and alcohol may be particularly useful for designing strategies to reduce, HIV sexual transmission in South Africa. 相似文献
7.
We examined whether sexual attitudes of adolescents were related to their self-reported sexual risk behavior by analyzing survey data from 1,052 boys and girls aged 14 to 17 years from a low income, urban community. Sexual behavior norms that may increase sexually transmitted infection/HIV risks in youth were sanctioned more by males and by sexually experienced youth, but their attitudes were unassociated with either their age or race/ethnicity. Endorsement was correlated with greater intention to have sexual intercourse among all youth. Among sexually experienced participants, it was associated with earlier sexual debut, more partners, and less intention to use condoms but not with the number of unprotected sexual episodes in the prior six months. Sexual attitudes of youth may conflict with initiation and maintenance of safer sex practices, making them vulnerable to HIV and other sexually transmitted infections. Risk reduction interventions for adolescents should address this. 相似文献
8.
Van Dorn RA Mustillo S Elbogen EB Dorsey S Swanson JW Swartz MS 《Child abuse & neglect》2005,29(11):1265-1279
OBJECTIVE: There were two aims: first, to examine the relationship between prior sexual abuse and three types of adult risky sexual behaviors [(1) ever traded sex for drugs or money, (2) had unprotected sex in the past 6 months, and (3) frequency of unprotected sex in the past 6 months] among persons with severe mental illness (SMI), and second, to examine the potential mediating effects of adult rape, substance use, and PTSD. METHOD: Using a pooled sample of individuals with SMI (N=609), logistic and negative binomial regression analyses were used to investigate the impact of prior sexual abuse on these adult risky sexual behaviors. RESULTS: Childhood sexual abuse was associated with having ever traded sex for money and having engaged in unprotected sex in the past 6 months. However, childhood sexual abuse was inversely associated with the number of times males had unprotected sex in the past 6 months. Results differed between males and females and the impact of potential mediators also varied by gender and type of outcome studied. CONCLUSION: These findings suggest a complex link between childhood sexual abuse and adult risky sexual behaviors in persons with SMI. Clinical assessments of child abuse sequelae should include a variety of indicators and parameters of adult risky sexual behavior, as persons with SMI are at an increased risk of engaging in high-risk sexual behaviors and tend to have a higher exposure to childhood sexual abuse than does the general population. 相似文献
9.
This study aimed to examine the pathways from child sexual abuse to sexual assault victimization and perpetration in adolescence and early adulthood, considering risky sexual behavior and lowered sexual self-esteem as mediator variables. In a two-wave longitudinal study with 2251 college students in Germany, male and female participants provided reports of sexual aggression victimization and perpetration since age 14 (T1) and again a year later (T2), covering the last 12 months. In addition, child sexual abuse (CSA; before the age of 14), risky sexual behavior, and sexual self-esteem were assessed at T1, and risky sexual behavior and sexual-self-esteem were assessed again at T2. Experience of CSA was significantly associated with greater likelihood of sexual aggression victimization and perpetration, lower sexual self-esteem, and more risky sexual behavior in both gender groups at T1 and was directly related to victimization at T2 among male participants. In both gender groups, CSA indirectly contributed to a higher probability of sexual victimization at T2 via its impact on victimization T1. In males, the indirect path from CSA to T2 perpetration via T1 perpetration was also significant. Through its negative impact on sexual self-esteem, CSA indirectly increased the probability of sexual victimization among women and the probability of sexual aggression perpetration among men. Risky sexual behavior mediated the pathway from CSA to sexual victimization at T2 for men and women and the pathway from CSA to sexual aggression perpetration for women. The findings contribute to the understanding of gendered effects of CSA on revictimization and the victim-to-perpetrator cycle. 相似文献
10.
Holmes WC 《Child abuse & neglect》2008,32(1):83-97
OBJECTIVES: To estimate how many heterosexual and gay/bisexual men self-define abusive childhood sexual experiences (CSEs) to be childhood sexual abuse (CSA) and to assess whether CSA self-definition is associated with risky behavioral and psychiatric outcomes in adulthood. METHODS: In Philadelphia County, 197 (66%) of 298 recruited men participated in a telephone survey. They were screened for CSEs and then asked if they self-defined abusive CSEs to be CSA; they also were asked about risk behavior histories and post-traumatic stress disorder (PTSD) and depression symptoms. RESULTS: Of 43 (22%) participants with abusive CSEs, 35% did not and 65% did self-define abusive CSEs to be CSA ("Non-Definers" and "Definers," respectively). Heterosexual and gay/bisexual subgroups' CSA self-definition rates did not significantly differ. When self-definition subgroups were compared to those without CSEs ("No-CSEs"), Non-Definers had lower perceived parental care (p=.007) and fewer siblings (p=.03), Definers had more Hispanics and fewer African Americans (p=.04), and No-CSEs had fewer gay/bisexual men (p=.002) and fewer reports of physical abuse histories (p=.02) than comparison groups. Non-Definers reported more sex under the influence (p=.001) and a higher mean number of all lifetime sex partners (p=.004) as well as (only) female sex partners (p=.05). More Non-Definers than Definers reported having experienced penetrative sex as part of their CSA (83% vs. 35%, p=.006). Different explanations about self-definition were provided by subgroups. CONCLUSIONS: Many men with abusive CSEs do not self-define these CSEs to be CSA, though not in a way that differs by sexual identity. The process by which men self-define their abusive CSEs to be CSA or not appears to be associated not only with self-explanations that differ by self-definition subgroup, but also with behavioral outcomes that impart risk to Non-Definers. 相似文献
11.
Women with histories of child sexual abuse (CSA) are more likely than those without such experiences to report a variety of negative sexual outcomes. This study examines the explanatory power of a CSA summed composite versus dichotomous (presence/absence) measurement in predicting a comprehensive negative sexual behavior outcome. Study participants were obtained from a community based sample examining women's sexual decision-making. The continuous CSA measurement reflects cumulative histories of CSA through a composite score capturing abuse specific characteristics. Using a cross-validation approach, the sample (n = 835) was randomly split and the explanatory power of each measure was examined through a series of multiple linear regressions comparing model fit indexes and performing a formal likelihood ratio test of one model against another. All CSA measures explained a similar percentage of variance but overall the CSA summed composite explained the data significantly better in terms predicting negative sexual experiences and revictimization than a binary measure as demonstrated with the likelihood ratio test. The results were replicated by cross-validating the predictive power of the CSA composite score between the split samples. Consistency of CSA regression estimates for the summed composite between training and validation samples were also confirmed. Given the superiority of the CSA summed composites over the binary variable, we recommend using this measure when examining associations between CSA histories and negative sexual experiences and revictimization. 相似文献
12.
《Child abuse & neglect》2014,38(11):1848-1859
Research suggests that adverse events in childhood, such as childhood physical, sexual, and emotional abuse, confer risk for later sexual assault. Psychological distress, coping strategies, and sexual behavior may help explain the path from childhood abuse to revictimization. The present study explored how the use of sex to regulate negative affect (SRNA) operates independently, and in combination with other psychosocial factors to increase college women's (N = 541) risk of experiencing prospective adult sexual assault (ASA). Sequential multiple mediator models in Mplus were used to assess the effect of three different forms of childhood abuse on prospective ASA, both independently and while controlling for other forms of childhood abuse. The indirect effect of adolescent sexual assault (AdolSA), depressive symptoms, SRNA, and participants’ response to a sex-related vignette was tested using bias-corrected bootstrapping. In the full path model, childhood emotional abuse and AdolSA predicted ASA, while childhood physical and sexual abuse were directly associated with AdolSA, but not ASA. Additionally, depressive symptoms and participants’ estimate of their likely behavior in a sex-related vignette directly predicted prospective ASA. Results using bootstrapping revealed that a history of childhood abuse predicted prospective ASA via diverse direct and indirect paths, as well as through a similar multiple mediator path. Overall, findings suggest that a combination of affective, coping, and sexual expectancy factors contribute to risk for revictimization in adult survivors of childhood abuse. Future research directions and targets for risk-reduction programming are discussed. 相似文献
13.
A review of the short-term effects of child sexual abuse 总被引：6，自引：2，他引：6
This is the first of a two-part report that critically evaluates empirical studies on the short- and long-term effects of child sexual abuse. With the exception of sexualized behavior, the majority of short-term effects noted in the literature are symptoms that characterize child clinical samples in general. Among adolescents, commonly reported sequelae include sexual dissatisfaction, promiscuity, homosexuality, and an increased risk for revictimization. Depression and suicidal ideation or behavior also appear to be more common among victims of sexual abuse compared to normal and psychiatric nonabused controls. Frequency and duration of abuse, abuse involving penetration, force, or violence, and a close relationship to the perpetrator appear to be the most harmful in terms of long-lasting effects on the child. The high prevalence of marital breakdown and psychopathology among parents of children who are sexually abused makes it difficult to determine the specific impact of sexual abuse over and above the effects of a disturbed home environment. Given the broad range of outcome among sexual abuse victims, as well as the methodological weaknesses present in many of the studies reviewed, it is not possible at this time to postulate the existence of a "post-sexual-abuse-syndrome" with a specific course or outcome. 相似文献
14.
In this paper we employed a prospective design to examine the effect of child sexual abuse (CSA) on life-course offending by comparing victims to both their siblings and random controls in the Netherlands. Information on victimization was gathered from court files and on offending from official criminal records. We found that victims of CSA were more at risk of offending than random controls, but so were their siblings. Only female victims were more likely to offend than their own siblings. The increased risk for offending was not specifically found for sexual offenses, instead it was found for various types of offenses. The found difference between female victims and siblings held true for abuse perpetrated by someone outside the family. We therefore conclude that family and environmental factors are the most important to explain offending among male CSA victims, while these factors alone are not enough to explain the effect of CSA on offending for females. 相似文献
15.
OBJECTIVES: This study aimed to explore factors relating to intention to participate in community child sexual abuse (CSA) prevention programs among Chinese adults in Hong Kong. METHOD: A total of 1,606 Chinese adults (497 men and 1,109 women) were individually interviewed about their intention to participate in community CSA prevention programs, endorsement of myths about CSA, their acquaintance with CSA victims, worry about CSA, and perceived prevalence of CSA. RESULTS: Among participants, nearly two-thirds believed CSA involved physical injuries of victims, 40% perceived boys as unlikely victims of CSA, and one-third were skeptical about children reports of CSA. About 24% of participants reported that they would definitely take part in CSA prevention programs. Participants who showed definite intention to participate in these programs endorsed fewer myths in relation to CSA, showed more worry about children being at risk of sexual abuse, perceived CSA as more prevalent and involving more physical injuries of victims, and were more likely to be women. CONCLUSIONS: Attention should be addressed to predisposing factors of adult participation in CSA prevention programs. 相似文献
16.
OBJECTIVE: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents. METHOD: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and recent history of sexual coercion were used to predict physiologically confirmed STI acquisition over the subsequent 6 months. RESULTS: About 38% of all girls reported a history of childhood sexual abuse (CSA). Girls with a history of CSA were more likely to report recent sexual coercion. In turn, sexual coercion in the last three months was significantly associated with a higher number of sexual partners (but not with a greater frequency of intercourse or with lower rates of condom use). Number of sexual partners significantly predicted the future acquisition of an STI within 6 months. CONCLUSIONS: Interventions to reduce risky sexual behaviors in homeless adolescent females may need to consider the impact of CSA, particularly on the number of sexual partners during adolescence. However, it also should be noted that engagement in intercourse often results from coercion and is not voluntary in this population. 相似文献
17.
Purpose: Using a Syndemics Theory conceptual model, this study examines the relationship between emotional neglect experiences during childhood and/or adolescence and involvement in HIV risk taking in a sample of adult men who actively seek partners for unprotected sex via the Internet. Methods: The study was based on a national random sample of 332 MSM who use the Internet to seek men with whom they can engage in unprotected sex. Data collection was conducted via telephone interviews between January 2008 and May 2009. Structural equation analysis was undertaken to examine the specific nature of the relationships involved in understanding HIV risk practices. Results: Emotional neglect was highly prevalent among the men participating in this study. Emotional neglect experiences were not found to be related directly to involvement in HIV risk taking in adulthood. Emotional neglect, was found to be an important variable in the overall structural equation. Its effect on HIV risk taking was indirect, operating principally by having a negative impact upon self-esteem, which in turn had a negative effect on attitudes toward condom use, which in turn were related strongly and directly to risk taking. Conclusions: Childhood experiences with emotional neglect are relevant to understanding HIV risk practices among MSM in adulthood, but the relationship is not as simple as usually conceptualized. Rather, emotional neglect appears to impact risk taking indirectly, through its effects on mental health functioning, which in turn affects risk-related attitudes. 相似文献
18.
OBJECTIVE: To establish the prevalence, typology and nature of attempted or completed incidents of stranger-perpetrated sexual abuse or abduction of children "away from home". METHODS: A questionnaire was completed by 2,420 children (83% response rate) aged 9-16 years in 26 elementary and high schools in North-West England. RESULTS: Of these children, 19.0% (n=461) reported that they had been the victims of any attempted or completed sexual abuse or abduction incident away from home at some point in their lives. Of these children, 161 (6.7% of the original sample) reported that the "last" incident had been perpetrated by a stranger. Based upon these last incidents, four main types of attempted or completed CSA or abduction incident were identified: indecent exposure (40.8% of victims), touching (25.8%), and abduction (23.1%), each occurring on their own; and incidents involving multiple types of act (10.2%). The majority of these abductions (91.1%) and touching incidents (50.9%) were attempted as opposed to completed. Rates of victimization were generally higher among girls than boys (10.4% vs. 4.2%, p<.001). A sizeable minority of victims had experienced sexual abuse or abduction previously (28.8%). The large majority of incidents were carried out by males (88.2%). Most incidents occurred when children were accompanied by their peers (67.9%). Many victims were frightened by their experience (46.9% very frightened) and the large majority made a disclosure (79.9%). Only a minority of incidents were reported to the police (33.3%). CONCLUSIONS: Incidents of attempted and completed stranger CSA and abduction are distinct from CSA and abduction by known persons, go against stereotypes, are complex, and give rise to a number of key issues that may have implications for prevention and intervention. PRACTICE IMPLICATIONS: Professionals involved in child protection should undertake work to reduce the risk of existing victims of CSA or abduction becoming victims of stranger CSA or abduction, and the risk of attempted incidents becoming completed ones. They also need to encourage the disclosure and reporting of attempted and completed stranger CSA and abduction incidents. 相似文献
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20.
Nolan M O'Flaherty A Turner R Keary K Fitzpatrick C Carr A 《Child abuse & neglect》2002,26(4):333-348
OBJECTIVE: This study aimed to profile subgroups of CSA cases referred for assessment at two national CSA assessment centers in Ireland. METHOD: Historical and clinical data for 150 CSA cases were drawn from records of two Dublin-based national specialist sexual abuse assessment and therapeutic centers. Three main comparisons were made involving: (1) 113 confirmed CSA cases and 37 unconfirmed CSA cases, (2) 55 confirmed CSA cases that displayed clinically significant behavior problems, and the 56 confirmed CSA cases without significant adjustment difficulties, and (3) 19 confirmed CSA cases in which violence was a central feature, and 79 confirmed cases in which violence was not a central feature. RESULTS: There were three main findings. (1) More unconfirmed cases were male; had single or separated parents; and a father with a criminal history. As a group, the confirmed cases were largely youngsters who had been abused by male adults or adolescents outside their nuclear family and who subsequently were well supported by one or two parents. (2) Poorly adjusted CSA victims had a history of coercive violent abuse while better adjusted children were victims of nonviolent abuse. (3) Victims of violent CSA were more likely to have experienced penetrative abuse and to display more externalizing behavior problems. CONCLUSIONS: Confirmed and unconfirmed CSA cases, well and poorly adjusted CSA cases, and victims of violent and nonviolent CSA referred for assessment at two national CSA assessment centers in Ireland had distinctive clinical profiles. 相似文献