The Relationship Between Sexual Abuse and Risky Sexual Behavior Among Adolescent Boys: A Meta-Analysis

ArticleinJournal of Adolescent Health 51(1):18-24 · July 2012with49 Reads
DOI: 10.1016/j.jadohealth.2011.12.032 · Source: PubMed
Abstract
Childhood and adolescent sexual abuse has been shown to lead to increased odds of sexual behaviors that lead to sexually transmitted infections and early pregnancy involvement. Research, meta-analyses, and interventions, however, have focused primarily on girls and young women who have experienced abuse, yet some adolescent boys are also sexually abused. We performed a meta-analysis of the existing studies to assess the magnitudes of the link between a history of sexual abuse and each of the three risky sexual behaviors among adolescent boys in North America. The three outcomes were (a) unprotected sexual intercourse, (b) multiple sexual partners, and (c) pregnancy involvement. Weighted mean effect sizes were computed from ten independent samples, from nine studies published between 1990 and 2011. Sexually abused boys were significantly more likely than nonabused boys to report all three risky sexual behaviors. Weighted mean odds ratios were 1.91 for unprotected intercourse, 2.91 for multiple sexual partners, and 4.81 for pregnancy involvement. Our results indicate that childhood and adolescent sexual abuse can substantially influence sexual behavior in adolescence among male survivors. To improve sexual health for all adolescents, even young men, we should strengthen sexual abuse prevention initiatives, raise awareness about male sexual abuse survivors' existence and sexual health issues, improve sexual health promotion for abused young men, and screen all people, regardless of gender, for a history of sexual abuse.
    • "First, we found differences in some but not all HIV sexual risk behaviors when comparing adolescents who had a history of forced sexual initiation with those who had no such history. In contrast to previous studies [41, 42], we did not observe a difference in condom use in the last sexual act between adolescents who reported forced sexual initiation and those who did not. However, the general low condom use in Nigeria, particularly in youths [43], makes it unlikely that meaningful changes could be observed. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. Methods: We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. Results: Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87), and transactional sex (OR: 2.80; 95% CI: 1.56-4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11) and loss and grief (OR: 1.34; 95% CI: 0.73-2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09-0.83). Conclusion: History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries.
    Full-text · Article · Apr 2016
    • "These deficits may contribute to the higher risk of early pregnancy, and increased incidences of sexually transmitted infections (STIs), including higher rates of HIV/AIDS, for these youth compared to their peers who were never in care (Ahrens, McCarty, Simoni, Dworsky, & Courtney, 2013). Many of the youth in the child welfare system have also suffered sexual abuse, which has been linked risky sexual behaviors and negative sexual health outcomes (Homma, Wang, Saewyc, & Kishor, 2012; Paolucci, Genuis, & Violato, 2001; Van Roode, Dickson, Herbison, & Paul, 2009). Given the vulnerabilities facing youth aging out of care, this population is of interest to social workers and other helping professionals. "
    [Show abstract] [Hide abstract] ABSTRACT: This review examines literature related to pregnancy, sexual health outcomes, and sexual risk behaviors for foster youth and youth who are aging/have aged out of foster care. Using the search terms foster youth, aging out, pregnancy, sexually transmitted diseases, sexually transmitted infections, sexual risk, sexual behavior, and sexual health, 26,376 sources were initially identified. After removing duplicate sources and those that did not meet inclusion criteria and adding others identified through the references of identified sources, 56 sources were included in the review. Outcome measures were grouped into broad categories of pregnancy, sexually transmitted infections, and risky sexual behaviors, with each having several subparts. Implications for social work practice and policy are presented and directions for future research are highlighted.
    Full-text · Article · Feb 2016
    • "A community mobiliser shared his experience of changing masculine ideals of excessive alcohol consumption: As mentioned in the methodology section, young men aged 18 to 35 years were the primary targets for the community mobilisation intervention along with their female counterparts. Young men and women in this age group are more likely to engage in sexual risk behaviours compared to younger adolescents and older adults (Charnigo et al. 2013; Homma et al. 2012). Both young men and women in this age group were the primary participants in intervention activities. "
    [Show abstract] [Hide abstract] ABSTRACT: One of the main contextual factors driving the HIV epidemic in Sub-Saharan Africa is shared social norms reinforcing restrictive masculine and feminine roles and inequitable gender relationships, which limit women’s ability to protect themselves from HIV while simultaneously putting social pressure on men to take on a range of sexual and health risks. A growing body of scholarship and programme development focuses on the impacts of engaging men and boys in reducing women’s and girls’ HIV vulnerability as well as improving men’s health and well being. To further understand the benefits of engaging men and boys for gender equality and HIV prevention, this study explores the impacts of the South African non government organisation, Sonke Gender Justice’s ‘One Man Can’ (OMC) community mobilisation approach in a multi level HIV prevention intervention to address the community level factors that contribute to women and girls’ increased HIV vulnerability and men’s HIV risk taking behaviour. This case study examines qualitative data collected as part of a gender equality and HIV prevention intervention implemented in rural South Africa that engaged men 18 to 35 years old to increase their support for girls’ and women’s rights and to decrease men’s unsafe sexual practices, especially those that increase girls’ and young women’s vulnerability to HIV infection. Our findings indicate significant attitudinal and some behavioural changes around gender and HIV risk amongst OMC community mobilisers, community action team (CAT) members, and community members exposed to the intervention. At the interpersonal level, adoption of gender equitable beliefs and values had positive effects of improved interpersonal communication and a more balanced division of labour in the home. At the community level, participation in collective activities and increased social awareness of men’s and women’s unique HIV vulnerabilities produced changes in community members’ lives and relationships and created new pathways for collective action for social change. Key lessons learned and potential policy implications are offered
    Full-text · Technical Report · Dec 2015 · Children and Youth Services Review
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