The University of Texas at Austin, School of Social Work, Center for Social Work Research, Austin, Texas 78712, USA.
Womens Health Issues. 2012 May-Jun;22(3):e283-92. doi: 10.1016/j.whi.2012.01.004. Epub 2012 Mar 3.
Sexually transmitted infections (STIs) are among the most common infections in the United States and are particularly prevalent in survivors of sexual violence. The purpose of this study is to examine co-occurring risk factors for sexual violence and STIs including mental health, alcohol use, drug use, and multiple partners as intersecting pathways to STIs for women who experienced sexual abuse in the past year.
Secondary analyses were conducted on cross-sectional data from women originally recruited as respondents for an epidemiologic survey funded by the Centers for Disease Control and Prevention (CDC): Project CHOICES. The survey was administered to 2,672 women in six settings: A large, urban jail and residential alcohol and drug treatment facilities (Texas); a gynecology clinic (Virginia); two primary care clinics (Virginia and Florida); and media solicitation (Florida). Women were included in the current study if they were fertile, sexually active, and not pregnant or trying to get pregnant (n = 1,183). Structural equation modeling (SEM) was used to test the conceptual path model between sexual violence and STI occurrence.
In the SEM, there were no significant paths from mental health, alcohol severity, or drug use to STI occurrence contrary to the results of the initial bivariate analyses. Multiple sexual partners significantly mediated the relationship between sexual violence and STIs and between mental health and drug use and STIs.
This study highlights the importance of providing effective treatment to survivors of sexual violence, which includes addressing risky sexual behaviors to reduce STI occurrence.
性传播感染（STIs）是美国最常见的感染之一，在性暴力幸存者中尤为普遍。本研究的目的是研究性暴力和 STIs 的共同风险因素，包括心理健康、酒精使用、药物使用和多个性伴侣，这些因素是过去一年遭受性虐待的女性发生 STIs 的交叉途径。
对来自疾病控制与预防中心（CDC）资助的一项流行病学调查的女性的横断面数据进行二次分析：CHOICES 项目。该调查在六个地点对 2672 名女性进行了调查：一个大型城市监狱和住宅酒精和药物治疗设施（德克萨斯州）；妇科诊所（弗吉尼亚州）；两个初级保健诊所（弗吉尼亚州和佛罗里达州）；和媒体征集（佛罗里达州）。如果女性有生育能力、有性行为且未怀孕或试图怀孕（n=1183），则纳入本研究。结构方程模型（SEM）用于测试性暴力与 STI 发生之间的概念路径模型。
在 SEM 中，与初始双变量分析的结果相反，心理健康、酒精严重程度或药物使用与 STI 发生之间没有显著关系。多个性伴侣显著中介了性暴力与 STIs 之间以及心理健康与药物使用和 STIs 之间的关系。
本研究强调了为性暴力幸存者提供有效治疗的重要性，其中包括解决危险的性行为，以减少 STI 的发生。
