London Stephanie, Quinn Kelly, Scheidell Joy D, Frueh B Christopher, Khan Maria R
From the *New York University School of Medicine; †Department of Population Health, New York University School of Medicine, New York, NY; and ‡Department of Psychology, Division of Social Sciences, University of Hawaii, Honolulu, Hawaii.
Sex Transm Dis. 2017 Sep;44(9):524-532. doi: 10.1097/OLQ.0000000000000640.
Childhood maltreatment, particularly sexual abuse, has been found to be associated with sexual risk behaviors later in life. We aimed to evaluate associations between a broad range of childhood traumas and sexual risk behaviors from adolescence into adulthood.
Using data from Waves I, III and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we used logistic regression to estimate the unadjusted odds ratio (OR) and adjusted OR (AOR) for associations between 9 childhood traumas and a cumulative trauma score and three sexual risk outcomes (multiple partnerships, sex trade involvement, and sexually transmitted infection [STI]) in adolescence, young adulthood, and adulthood. We also examined modification of these associations by gender.
Associations between cumulative trauma score and sexual risk outcomes existed at all waves, though were strongest during adolescence. Dose-response-like relationships were observed during at least 1 wave of the study for each outcome. Violence exposures were strong independent correlates of adolescent sexual risk outcomes. Parental binge drinking was the only trauma associated with biologically confirmed infection in young adulthood (AOR, 1.46; 95% confidence interval [CI], 1.01-2.11), whereas parental incarceration was the trauma most strongly associated with self-reported STI in adulthood (AOR, 1.70; 95% CI, 1.11-2.58). A strong connection was also found between sexual abuse and sex trade in the young adulthood period (AOR, 2.17; 95% CI, 1.43-2.49).
A broad range of traumas are independent correlates of sex risk behavior and STI, with increasing trauma level linked to increasing odds of sexual risk outcomes. The results underscore the need to consider trauma history in STI screening and prevention strategies.
研究发现童年期受虐，尤其是性虐待，与日后生活中的性风险行为有关。我们旨在评估一系列童年创伤与从青春期到成年期的性风险行为之间的关联。
利用青少年到成人健康全国纵向研究（Add Health）第一、三、四轮的数据，我们使用逻辑回归来估计9种童年创伤和累积创伤评分与青春期、青年期和成年期的三种性风险结果（多个性伴侣、参与性交易和性传播感染[STI]）之间关联的未调整优势比（OR）和调整后优势比（AOR）。我们还研究了这些关联在性别上的差异。
累积创伤评分与性风险结果之间的关联在所有轮次中均存在，尽管在青春期最为强烈。对于每种结果，在研究的至少一轮中观察到了类似剂量反应的关系。暴力暴露是青少年性风险结果的强独立相关因素。父母酗酒是与青年期经生物学确诊感染唯一相关的创伤（AOR，1.46；95%置信区间[CI]，1.01 - 2.11），而父母入狱是成年期与自我报告的性传播感染最强烈相关的创伤（AOR，1.70；95%CI，1.11 - 2.58）。在青年期，性虐待与性交易之间也发现了紧密联系（AOR，2.17；95%CI，1.43 - 2.49）。
一系列创伤是性风险行为和性传播感染的独立相关因素，创伤水平越高，性风险结果的几率越高。结果强调在性传播感染筛查和预防策略中需要考虑创伤史。
