Department of Maternal and Child Health and the Carolina Population Center, University of North Carolina at Chapel Hill, USA.
Perspect Sex Reprod Health. 2011 Mar;43(1):16-22. doi: 10.1363/4301611. Epub 2010 Nov 23.
Given the threat posed by STDs in young adulthood, identifying early predictors of STD risk is a priority. Exposure to childhood maltreatment has been linked to sexual risk behaviors, but its association with STDs is unclear.
Associations between maltreatment by parents or other adult caregivers during childhood and adolescence and STD outcomes in young adulthood were examined using data on 8,922 respondents to Waves 1, 3 and 4 of the National Longitudinal Study of Adolescent Health. Four types of maltreatment (sexual abuse, physical abuse, supervision neglect and physical neglect) and two STD outcomes (self-reported recent and test-identified current STD) were assessed. Multivariate logistic regression analyses, stratified by sex, tested for moderators and mediators.
Among females, even after adjustment for socioeconomic and demographic characteristics, self-report of a recent STD was positively associated with sexual abuse (odds ratio, 1.8), physical abuse (1.7), physical neglect (2.1) and supervision neglect (1.6). Additionally, a positive association between physical neglect and having a test-identified STD remained significant after further adjustments for exposure to other types of maltreatment and sexual risk behaviors (1.8). Among males, the only association (observed only in an unadjusted model) was between physical neglect and test-identified STD (1.6).
Young women who experienced physical neglect as children are at increased risk of test-identified STDs in young adulthood, and exposure to any type of maltreatment is associated with an elevated likelihood of self-reported STDs. Further research is needed to understand the behavioral mechanisms and sexual network characteristics that underlie these associations.
鉴于性传播疾病(STD)在青年时期构成的威胁,确定 STD 风险的早期预测因素是当务之急。有研究表明,儿童期受虐待与性风险行为有关,但与 STD 之间的关联尚不清楚。
利用全国青少年健康纵向研究的第 1、3 和 4 波数据,对 8922 名受访者进行分析,以确定儿童期和青少年时期遭受父母或其他成年照顾者的虐待与成年早期 STD 结局之间的关联。评估了 4 种类型的虐待(性虐待、身体虐待、监管忽视和身体忽视)和 2 种 STD 结局(自我报告的近期和检测确定的当前 STD)。采用多元逻辑回归分析,按性别分层,检验了调节因素和中介因素。
在女性中,即使在调整了社会经济和人口统计学特征后,自我报告的近期 STD 与性虐待(比值比,1.8)、身体虐待(1.7)、身体忽视(2.1)和监管忽视(1.6)呈正相关。此外,在进一步调整了暴露于其他类型的虐待和性行为风险后,身体忽视与检测确定的 STD 之间的正相关仍然显著(1.8)。在男性中,仅存在一种关联(仅在未经调整的模型中观察到),即身体忽视与检测确定的 STD(1.6)之间的关联。
儿童时期经历身体忽视的年轻女性在成年早期患有检测确定的 STD 的风险增加,并且任何类型的虐待暴露都与自我报告的 STD 发生的可能性增加相关。需要进一步研究来了解这些关联背后的行为机制和性网络特征。