Brown Monique J, Masho Saba W, Perera Robert A, Mezuk Briana, Cohen Steven A
College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA.
Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Child Abuse Negl. 2015 Aug;46:89-102. doi: 10.1016/j.chiabu.2015.02.019. Epub 2015 Mar 21.
Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.
童年不良经历（ACEs）与过早开始性行为有关，而过早开始性行为已被发现与多种不良健康后果相关。与异性恋人群和女性相比，性少数群体和男性往往更早开始性行为。然而，缺乏关于ACEs与男性及性少数群体过早开始性行为之间关联的研究。本研究的目的是探讨ACEs与首次性行为年龄之间关联中的性别和性取向差异。数据来自全国酒精及相关状况流行病学调查的第二轮。使用逻辑回归和线性回归模型来获得粗略估计值和调整后的估计值以及95%置信区间，针对ACEs（忽视、身体/心理虐待、性虐待、父母暴力、父母监禁和精神病理学）与过早开始性行为之间的关联，调整年龄、种族/族裔、收入、教育程度、保险和婚姻状况。分析按性别和性取向进行分层。与男性相比，女性以及在性少数群体中，特别是与异性恋者相比，在男男性行为者（MSM）和女女性行为者（WSW）中，ACEs与首次性行为之间关联的效应估计值更大。侧重于延迟儿童和青少年首次性行为的性健康教育项目也应考虑解决ACEs问题，如忽视、身体、心理和性虐待、目睹父母暴力以及父母监禁和精神病理学。公共卫生从业者、研究人员和性健康教育课程协调员在设计这些项目时应考虑这些性别和性取向差异。
