Department of Population Health, New York University School of Medicine, New York.
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park.
Perspect Sex Reprod Health. 2020 Mar;52(1):23-30. doi: 10.1363/psrh.12129. Epub 2020 Feb 24.
Receptive anal intercourse (RAI), which has become increasingly common among U.S. heterosexual women, is associated with STDs, including HIV, when it is unprotected and coercive. Childhood traumatic experiences may increase sexual risk behavior, but the relationship between childhood trauma and RAI among women has not been examined.
Data from 4,876 female participants in Waves 1 (1994-1995), 3 (2001-2002) and 4 (2007-2008) of the National Longitudinal Study of Adolescent to Adult Health were used to examine associations between nine self-reported childhood traumas (neglect; emotional, physical and sexual abuse; parental binge drinking and incarceration; and witnessing, being threatened with and experiencing violence) and RAI during adulthood using modified Poisson regression analysis. Whether depression, low self-esteem, drug use, relationship characteristics or sex trade involvement mediated the relationship between trauma and RAI was also explored.
Forty percent of the sample reported having engaged in receptive anal intercourse. After adjustment for sociodemographic characteristics, eight of the nine childhood traumas were associated with increased risk of RAI (adjusted prevalence ratios, 1.2-1.5); the strongest association was with experience of violence. Each unit increase in the number of traumas yielded a 16% increase in RAI prevalence. In mediation analyses, only drug use and relationship factors slightly attenuated the association between childhood trauma and RAI (1.2 for each).
Women with a history of childhood trauma may be at increased risk of engaging in RAI, highlighting the importance of screening and trauma-informed education in sexual health settings. Pathways linking childhood trauma and RAI among women are complex and warrant further research.
接受肛交（RAI）在 美国异性恋女性中越来越普遍，当它没有保护措施且是强迫性行为时，与 STD 包括 HIV 有关。童年创伤经历可能会增加性行为风险，但女性童年创伤与 RAI 之间的关系尚未得到研究。
利用来自全国青少年至成人健康纵向研究的 4876 名女性参与者在第 1 波（1994-1995 年）、第 3 波（2001-2002 年）和第 4 波（2007-2008 年）的数据，采用修正泊松回归分析，研究了 9 种自我报告的童年创伤（忽视；情感、身体和性虐待；父母酗酒和监禁；以及目睹、受到威胁和经历暴力）与成年后 RAI 之间的关系。还探讨了抑郁、低自尊、药物使用、关系特征或性交易参与是否介导了创伤与 RAI 之间的关系。
样本中有 40%的人报告有过接受肛交的经历。在调整了社会人口统计学特征后，9 种童年创伤中有 8 种与 RAI 的风险增加相关（调整后的流行比，1.2-1.5）；与经历暴力的关联最强。创伤数量每增加一个单位，RAI 的流行率就会增加 16%。在中介分析中，只有药物使用和关系因素略微减弱了童年创伤与 RAI 之间的关联（每个关联因素的关联比为 1.2）。
有童年创伤史的女性可能有更高的 RAI 风险，这凸显了在性健康环境中进行筛查和以创伤为中心的教育的重要性。女性童年创伤与 RAI 之间的联系途径很复杂，需要进一步研究。
