Sexually Transmitted Diseases Among Adults Who Had Been Abused and Neglected as Children:A 30-Year Prospective Study

Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York, NY, USA.
American Journal of Public Health (Impact Factor: 4.55). 03/2009; 99 Suppl 1(S1):S197-203. DOI: 10.2105/AJPH.2007.131599
Source: PubMed


We examined associations between childhood abuse and neglect and the risk in adulthood for sexually transmitted diseases.
In a prospective cohort design, we matched children aged 0 to 11 years with documented cases of abuse or neglect during 1967 to 1971 with a control group of children who had not been maltreated (754 participants in all) and followed them into adulthood. Information about lifetime history of sexually transmitted diseases was collected as part of a medical status examination when participants were approximately 41 years old.
Childhood sexual abuse increased risk for any sexually transmitted disease (odds ratio [OR] = 1.94; 95% confidence interval [CI] = 1.00, 3.77; P = .05) and more than 1 type of sexually transmitted disease (OR = 3.33; 95% CI = 1.33, 8.22; P = .01). Physical abuse increased risk for more than 1 type of sexually transmitted disease (OR = 3.61; 95% CI = 1.39, 9.38; P = .009).
Our results provided the first prospective evidence that child physical and sexual abuse increases risk for sexually transmitted diseases. Early screening and interventions are needed to identify and prevent sexually transmitted diseases among child abuse victims.

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    • "For example, the situations in which maltreated children reside typically do not provide an enriching environment where children can learn emotional and behavioral regulation skills (Rellini, Vujanovic, Gilbert, & Zvolensky, 2012). Maltreated children are more likely to develop conditions or find themselves in situations that serve as additional risk factors, including substance abuse (Spatz Widom, Marmorstein, & Raskin White, 2006; Teicher, Samson, Polcari, & McGreenery, 2006) and higher rates of poverty, school dropout, juvenile delinquency, sexually transmitted diseases, and pregnancy (Crooks, Scott, Wolfe, Chiodo, & Killip, 2007; Hillis et al., 2004; Slack, Holl, McDaniel, Yoo, & Bolger, 2004; Wilson & Widom, 2009; Zielinski, 2009). Conversely, there are protective factors that improve the prognosis after maltreatment for some children (Afifi & MacMillan, 2011). "
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    ABSTRACT: Child maltreatment has the potential to alter a child's neurodevelopmental trajectory and substantially increase the risk of later psychiatric disorders, as well as to deleteriously impact neurocognitive functioning throughout the lifespan. Child maltreatment has been linked to multiple domains of neurocognitive impairment, including language, visual–spatial functioning, intelligence, executive functioning, and motor skills. Research is increasingly indicating that alterations in neurobiological functioning occur as a result of childhood maltreatment, which in turn may produce an epigenetic and transgenerational effect. School psychologists should be aware of these factors when working with maltreated children to better understand their current functioning and assessment results, and to educate family members, school personnel, and the community about the adverse effects of childhood maltreatment, as well as to work toward prevention.
    Psychology in the Schools 10/2014; 52(1). DOI:10.1002/pits.21806 · 0.72 Impact Factor
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    • "In addition, some were engaging in high-risk behaviours, such as trading sex, having multiple partners, having partners known to be intravenous drug users, and inconsistent condom use. The nature of the link between serious mental illness and high-risk sexual behaviour is likely to be complex and influenced by unstable psychiatric symptoms (such as hypersexuality), comorbid drug and alcohol problems (Meade & Sikkema 2007), and childhood and adulthood sexual abuse and exploitation (Meade et al. 2009; Wilson & Widom 2009). Prevalence studies indicate that people diagnosed with SMI might be at higher risk of sexually-transmitted infections (STI). "
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    ABSTRACT: People diagnosed with severe mental illness (SMI) are at greater risk of HIV than the general population. However, little attention has been given to how best to reduce sexual risk taking in this group. The aim of the review was to evaluate the effectiveness of behavioural interventions to promote sexual safety behaviour in people diagnosed with SMI. A comprehensive search of relevant databases was undertaken, and studies were included if they were randomized, controlled trials; behavioural intervention related to sexual behaviour; included adults diagnosed with SMI; and if a behavioural outcome was reported. The Cochrane Assessment of Bias Tool was used. Of the initial 515 papers identified, 11 trials were included for quality assessment and data extraction. The studies were heterogeneous in content and dose of intervention, as well as outcome measure and follow-up periods, and all had some risk of bias. Four of the studies demonstrated significant improvement in safer sexual behaviour at follow up, but this effect diminished over time. The effect sizes were extremely variable. There is emerging evidence to suggest that a behavioural intervention has the potential to reduce sexual risks in people diagnosed with SMI. However, further high-quality research is needed in this area.
    International journal of mental health nursing 04/2014; 23(4). DOI:10.1111/inm.12065 · 1.95 Impact Factor
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    • "Researchers have found an increased risk for STIs among women who experience intimate partner violence (IPV; Campbell et al., 2008; Gielen et al., 2007; Laughon et al., 2007; Wingood, DiClemente, & Raj, 2000) and child sexual abuse (CSA; Hillis, Anda, Felitti, & Marchbanks, 2001; Wilson & Widom, 2009). Support for the relationship between sexual violence in intimate relationships and an increase in both high-risk sexual behavior and STIs has also been documented (Campbell et al., 2008; Gielen et al., 2007; Maman, Campbell, Sweat, & Gielen, 2000; Stockman, Campbell, & Celentano, 2010). "
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    ABSTRACT: Interpersonal violence has increasingly been identified as a risk factor for sexually transmitted infections. Understanding the pathways between violence and sexually transmitted infections is essential to designing effective interventions. The aim of this study was to examine dissociative symptoms, alcohol use, and intimate partner physical violence and sexual coercion as mediators of child sexual abuse and lifetime sexually transmitted infection diagnosis among a sample of women. A convenience sample of 202 women was recruited from healthcare settings, with 189 complete cases for analysis. A multiple mediation model tested the proposed mediators of child sexual abuse and lifetime sexually transmitted infection diagnosis. Bootstrapping, a resampling method, was used to test for mediation. Key variables included child sexual abuse, dissociative symptoms, alcohol use, and intimate partner violence. Child sexual abuse was reported by 46% of the study participants (n = 93). Child sexual abuse was found to have an indirect effect on lifetime sexually transmitted infection diagnosis, with the effect occurring through dissociative symptoms (95% confidence interval = 0.0033-0.4714) and sexual coercion (95% confidence interval = 0.0359-0.7694). Alcohol use and physical violence were not found to be significant mediators. This study suggests that dissociation and intimate partner sexual coercion are important mediators of child sexual abuse and sexually transmitted infection diagnosis. Therefore, interventions that consider the roles of dissociative symptoms and interpersonal violence may be effective in preventing sexually transmitted infections among women.
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