School of Public Health, The University of Queensland, Public Health Building, Herston, 4006, Queensland, Australia.
School of Medicine, University of Queensland, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba 4102, Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada.
Child Abuse Negl. 2017 Jan;63:249-260. doi: 10.1016/j.chiabu.2016.11.023. Epub 2016 Nov 28.
This meta-analytic review examines the association between childhood sexual abuse and risky sexual behaviours with sub-group analyses by gender. Systematic searches of electronic databases including MEDLINE, PubMed, EMBASE, and PsycINFO were performed using key terms. We used a priori criteria to include high quality studies and control for heterogeneities across eligible studies. The review was registered with PROSPERO and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The final meta-analysis applied fixed-effects model to generate pooled odds ratio (OR). Subgroup analyses were conducted to identify potential methodological moderators. The meta-analysis included 8 eligible studies (N=38,989, females=53.1%). The overall syndemic of risky sexual behaviors at adulthood was 1.59 times more common in childhood sexual abuse victims. There was a similar association between childhood sexual abuse in general and subsequent risky sexual behaviors in both females and males. However, in cases of substantiated childhood sexual abuse, there was a greater odds of risky sexual behaviors in females (OR=2.72) than males (OR=1.69). The magnitude of association of childhood sexual abuse and risky sexual behaviors was similar for males and females regardless of study time, study quality score and method of childhood sexual abuse measurement. There were nonsignificant overall and subgroup differences between males and females. Childhood sexual abuse is a significant risk factor for a syndemic of risky sexual behaviors and the magnitude is similar both in females and males. More research is needed to explore possible mechanisms of association.
本荟萃分析回顾研究了儿童期性虐待与风险性行为之间的关联，并按性别进行了亚组分析。系统地检索了电子数据库，包括 MEDLINE、PubMed、EMBASE 和 PsycINFO，并使用了关键词。我们使用了预先设定的标准来纳入高质量的研究，并控制了合格研究之间的异质性。该综述在 PROSPERO 上进行了注册，并使用了系统评价和荟萃分析的首选报告项目指南。最终的荟萃分析采用固定效应模型生成合并优势比（OR）。进行了亚组分析以确定潜在的方法学调节因素。荟萃分析纳入了 8 项符合条件的研究（N=38989，女性=53.1%）。在成年期，风险性行为的总体综合征在儿童期性虐待受害者中更为常见，发生率为 1.59 倍。一般而言，儿童期性虐待与女性和男性随后的风险性行为之间存在类似的关联。然而，在经过证实的儿童期性虐待案例中，女性发生风险性行为的可能性（OR=2.72）大于男性（OR=1.69）。无论研究时间、研究质量评分和儿童期性虐待测量方法如何，儿童期性虐待与风险性行为之间的关联程度在男性和女性中相似。男性和女性之间在总体和亚组差异上均无统计学意义。儿童期性虐待是风险性行为综合征的一个重要危险因素，其程度在女性和男性中相似。需要进一步研究以探索关联的可能机制。
