Differences in Abortion Use by Sexual Orientation in 3 National Cohorts

Importance

Sexual minority individuals have less access to high-quality reproductive health care-including contraceptive care-and have higher rates of unintended pregnancies than their heterosexual peers. Little is known about differences in abortion use by sexual orientation.

Objective

To quantify differences in abortion use by sexual orientation.

Design, Setting, and Participants

This study using data from 3 North American cohorts included pregnancies between 1959 and 2024. Nurses' Health Study II (NHS2) is a cohort of female nurses in the US, Growing Up Today Study (GUTS) is a cohort of NHS2's offspring, and Nurses' Health Study 3 (NHS3) is a cohort of nurses and nursing students in the US and Canada.

Exposure

Sexual orientation (completely heterosexual, heterosexual with same-sex experience, mostly heterosexual, bisexual, and lesbian or gay).

Main Outcome and Measure

Participant-reported pregnancy outcome (induced abortion vs any other pregnancy outcome).

Results

Of a total of 235 948 pregnancies (with nonmissing pregnancy outcome data) across 85 640 participants, 211 095 pregnancies (89.5%) were to completely heterosexual participants, and 24 853 (10.5%) were to sexual minority participants. In GUTS and NHS3, there were a higher percentage of pregnancies to sexual minority participants (1546 [17.7%] and 7425 [19.7%], respectively) than in NHS2 (15 882 [8.4%]). In the cohorts combined, 20 243 pregnancies (8.6%) ended with an induced abortion. Compared with pregnancies to completely heterosexual participants, those to sexual minority participants were more likely to end with an induced abortion (risk ratio [RR], 1.93 [95% CI, 1.85-2.02]). Among sexual minority subgroups, heterosexual with same-sex experience (RR, 1.56 [95% CI, 1.47-1.66]), mostly heterosexual (RR, 2.15 [95% CI, 2.03-2.29]), bisexual (RR, 2.84 [95% CI, 2.49-3.23]), and lesbian or gay participants (RR, 2.52 [95% CI, 2.14-2.95]) had higher abortion use.

Conclusions and Relevance

In this study using data from retrospectively reported pregnancies from 3 longitudinal cohorts, all sexual minority groups had increased abortion use compared with completely heterosexual participants, and abortion use was heterogeneous; given the higher use of abortion among sexual minority populations, they are more likely to be disproportionately impacted by the narrowing of abortion access in the US after the Supreme Court Dobbs decision. Future research is needed to understand the pathways that contribute to the unique abortion care needs of sexual minority individuals, in order to provide adequate support for abortion seekers.

The Trends and Hotspots of Research on Adolescent Pregnancy: A Bibliometric Analysis

This bibliometric study aims to contribute to the literature on adolescent pregnancy by exploring gaps, research trends, contributing countries and journals, collaboration networks, and subject themes, offering a macro perspective on the field's development and future directions. This study employed a bibliometric research methodology. Publications containing the keywords adolescent, adolescence, youth, teenager, puberty, juvenile, pregnancy, and pregnant were retrieved from the Web of Science (WoS) database (1980-April 24, 2024) and analyzed using VOSviewer and the open-source R bibliometric package, adhering to predefined inclusion/exclusion criteria. The concept of adolescent pregnancy has been studied annually from 1980 to the present, peaking in 2022. Key research topics include sexual and reproductive health, contraception, and depression. According to Lotka's Law, 84.7% of authors in this field have published only once. Recent studies have focused on birth weight and pregnancy risks. The most cited publication globally and locally is by Ganchimeg et al., while the Journal of Adolescent Health is the most productive platform. The United States, Brazil, the United Kingdom, South Africa, Canada, and Turkey are the most productive countries in this field. The results of this study highlight that adolescent pregnancy remains a global public health issue, as evidenced by its consistent presence in annual research. Key research gaps and trends include social and emotional challenges faced by pregnant adolescents, physical development and health during adolescent pregnancy, causes and prevalence trends, preventive education services, and psychosocial interventions. Further research is essential to develop effective interventions for preventing adolescent pregnancy and safeguarding the best interests of children.

Caregiver and Child Adverse Childhood Experiences: A Meta-Analysis

CONTEXT

Exposure to adverse childhood experiences (ACEs) is associated with adverse impacts on subsequent generations. The extent to which caregiver ACEs are associated with their child's ACE score is unclear.

OBJECTIVE

To meta-analytically examine the association between caregiver and child ACE score. Potential moderators of this association were explored.

DATA SOURCES

Systematic searches were conducted using MEDLINE, Embase, PsycINFO, and CINHAL from 1998, the year the ACEs questionnaire was published, to February 19, 2024.

STUDY SELECTION

Inclusion criteria were that the ACEs questionnaire was completed for both caregiver and child, an effect size was available, and the study was published in English.

DATA EXTRACTION

Variables extracted included sample size and magnitude of association between caregiver ACEs and child ACEs, mean caregiver and child age, sex (% female), race and ethnicity, and informant of ACEs.

RESULTS

Seventeen samples (4872 caregiver-child dyads) met inclusion criterion. Results revealed a large pooled-effect size between caregiver and child ACEs (r = 0.33; 95% CI, 0.25-0.41; P < .001), such that higher caregiver ACEs score was associated with higher child ACEs score. This association was stronger among studies with younger caregivers and studies that utilized caregiver-report compared with child self-report of ACEs.

LIMITATIONS

Many studies were conducted in North America with female caregiver samples, limiting generalizability beyond these populations.

CONCLUSIONS

Caregiver ACEs were strongly associated with child ACEs. Prevention and intervention efforts for caregivers should be trauma informed and focused on bolstering protective factors that may break cycles of intergenerational risk.

A qualitative analysis of adolescent motherhood within the broader family context in Peru

Objective

The purpose of this study was to characterize the impact of adolescent pregnancy on families and describe the needs of adolescent mothers and their infants in order to assess the need for intervention and identify potential intervention targets.

Background

Adolescent mothers and their offspring face an increased risk of mental health problems. Adolescent mothers and their families also face significant resource constraints; 95% live in low- and middle-income countries (LMICs). Cost-effective interventions are needed to improve outcomes for this vulnerable group.

Method

This qualitative study conducted in Lima, Peru, consisted of four clinician focus groups and 18 in-depth interviews with adolescent mothers and their family members. Data were coded thematically, and direct content analysis was employed.

Results

The study identified the following issues facing adolescent parents: the transition to parenthood, the need for family support, difficulty accessing support, the difficulty for family members of providing support, and ideas about responsibility and adolescent autonomy.

Conclusion

Overall, these findings demonstrate the need for interventions that engage families and address barriers to accessing support, including relationship conflict and differing beliefs about responsibility and autonomy.

Implications

Interventions are needed for adolescent mothers in LMICs that mobilize family support. Clinicians who care for these patients need to be aware of the family context and the resources available where they practice.

Stolen innocence: Dishonor and taint in times of war

As soon as they are taken prisoner, children and adolescents in times of war are inserted into a spiral of cruelty that progresses to rape or other countless forms of physical and psychological torture using sex as a weapon. Were these children and adolescents war sex slaves? Oral sex and other sexual barbarities are part of spaces of abuse and humiliation. The damage to the personality structure of these children and adolescents is severe. The psychological consequences are numerous. Over the years, a vicious circle has been observed around this brutality.

Intergenerational Cycles of Maltreatment: A Scoping Review of Psychosocial Risk and Protective Factors

Child maltreatment tends to show intergenerational continuity. However, a significant proportion of maltreated parents break these cycles. Since several studies have investigated risk and protective factors associated with the intergenerational continuity of child maltreatment over the past decades, and no systematic review of the literature is available, this scoping review aimed to summarize studies documenting associated psychosocial risk and protective factors. A secondary objective was to document the prevalence of this phenomenon. A search in six major databases (PsycINFO, Scopus, Medline, Social Work Abstracts, ProQuest Dissertations/Theses, and Web of Science) was conducted. Studies involving human participants, presenting original findings, written in French or English, and of any type of design were included. There was no limit regarding the date of publication, except for theses/dissertations (5 years). A final sample of 51 papers was retained, 33 providing data on risk and protective factors and 18 providing only prevalence data. Results indicate that parents' individual characteristics (e.g., mental health, age), childhood adversity (e.g., multiple forms of adversity), relational (e.g., couples' adjustment, attachment, social support), and contextual factors (e.g., disadvantage, community violence) are relevant to the intergenerational continuity of child maltreatment. Prevalence rates of continuity ranged from 7% to 88%. Major limitations of reviewed studies are discussed. Continued efforts to uncover the mechanisms associated with the intergenerational continuity of child maltreatment using strong methodological designs are necessary. Knowledge in this area could lead to the development of effective prevention strategies (e.g., mental health services for parents, family/dyadic interventions) to break harmful intergenerational cycles of violence.

Racial/Ethnic Differences in Unwanted Pregnancy: Moderation by Sexual Orientation

OBJECTIVE

To explore sexual orientation disparities in unwanted pregnancy by race/ethnicity.

BACKGROUND

Previous research has documented that sexual-minority women (SMW) are more likely to report unplanned pregnancy than heterosexual women, and that Black and Latina women are more likely to report unplanned pregnancy than White women. No research has examined how pregnancy intention varies at the intersection of these two identities.

METHOD

Data come from the pregnancy roster data in Waves IV and Wave V subsample in the National Longitudinal Study of Adolescent to Adult Health. We used pregnancy as the unit of analysis (n=10,845) and multilevel logistic regression models to account for clustering of pregnancies within women. Per pregnancy, women were asked if they "wanted" to be pregnant at the time of pregnancy. We conducted models stratified by race/ethnicity, as well as models stratified by sexual identity.

RESULTS

Among White women, sexual-minority women were more likely to describe their pregnancy as unwanted than were their heterosexual counterparts. Conversely, among Black and Latina women, sexual-minority women were less likely to describe their pregnancy as unwanted than were their heterosexual counterparts. Results stratified by sexual identity underscore these contrasting patterns: Among heterosexual women, White women were less likely to describe their pregnancies as unwanted compared to Black and Latina women; among sexual-minority women, White women were more likely to describe their pregnancy as unwanted than were Black and Latina women.

CONCLUSION

Traditional race/ethnicity trends in pregnancy intention (i.e., greater unwanted pregnancy among Black/Latina than White women) are reversed among sexual-minority women.

Childhood experiences of maltreatment, reflective functioning and attachment in adolescent and young adult mothers: Effects on mother-infant interaction and emotion regulation

BACKGROUND

Maternal childhood experiences of maltreatment affect parenting and have consequences for a child's social-emotional development. Adolescent mothers have a higher frequency of a history of maltreatment than adult mothers. However few studies have analyzed the interactions between adolescent mothers with a history of childhood maltreatment and their infants.

OBJECTIVE

The aim of the study was to examine the effect of maternal childhood experiences of maltreatment on mother-infant emotion regulation at infant 3 months, considering both infant and mother individual emotion regulation and their mutual regulation.

PARTICIPANTS

Participants were 63 adolescent and young adult mother-infant dyads recruited at a hospital.

METHODS

The mothers were administered the Adult Attachment Interview to evaluate reflective functioning and attachment and the Childhood Experiences of Care and Abuse was used to evaluate maternal childhood experiences of maltreatment. Mother-infant interactions were coded with a modified version of the Infant Caregiver Engagement Phases.

RESULTS

Dyads with mothers with childhood maltreatment (vs dyads with mothers with no maltreatment) spent more time in negative emotional mutual regulation (p = .009) and less time in positive and neutral mutual emotion regulation (p = .019). Cumulative maternal childhood experiences of maltreatment were associated positively with mother and infant negative states at individual and dyadic level and with the AAI scales of Passivity and Unresolved Trauma (p < .05). The effect of cumulative maternal childhood experiences of maltreatment on mother-infant emotion regulation was direct and not mediated by maternal attachment and reflective function.

CONCLUSIONS

Maternal childhood experiences of maltreatment increase the risk connected to early motherhood, affecting mother-infant emotion regulation.

Ambulatory Blood Pressure Trajectory and Perceived Stress in Relation to Birth Outcomes in Healthy Pregnant Adolescents

OBJECTIVE

An early decline in resting blood pressure (BP), followed by an upward climb, is well documented and indicative of a healthy pregnancy course. Although BP is considered both an effector of stress and a clinically meaningful measurement in pregnancy, little is known about its trajectory in association with birth outcomes compared with other stress effectors. The current prospective longitudinal study examined BP trajectory and perceived stress in association with birth outcomes (gestational age (GA) at birth and birth weight (BW) percentile corrected for GA) in pregnant adolescents, a group at risk for stress-associated poor birth outcomes.

METHODS

Healthy pregnant nulliparous adolescents (n = 139) were followed from early pregnancy through birth. At three time points (13-16, 24-27, and 34-37 gestational weeks ±1 week), the Perceived Stress Scale was collected along with 24-hour ambulatory BP (systolic and diastolic) and electronic diary reporting of posture. GA at birth and BW were abstracted from medical records.

RESULTS

After adjustment for posture and pre-pregnancy body mass index, hierarchical mixed-model linear regression showed the expected early decline (B = -0.18, p = .023) and then increase (B = 0.01, p < .001) of diastolic BP approximating a U-shape; however, systolic BP displayed only an increase (B = 0.01, p = .010). In addition, the models indicated a stronger systolic and diastolic BP U-shape for early GA at birth and lower BW percentile and an inverted U-shape for late GA at birth and higher BW percentile. No effects of perceived stress were observed.

CONCLUSIONS

These results replicate the pregnancy BP trajectory from previous studies of adults and indicate that the degree to which the trajectory emerges in adolescence may be associated with variation in birth outcomes, with a moderate U-shape indicating the healthiest outcomes.

A putative causal relationship between genetically determined female body shape and posttraumatic stress disorder

Background

The nature and underlying mechanisms of the observed increased vulnerability to posttraumatic stress disorder (PTSD) in women are unclear.

Methods

We investigated the genetic overlap of PTSD with anthropometric traits and reproductive behaviors and functions in women. The analysis was conducted using female-specific summary statistics from large genome-wide association studies (GWAS) and a cohort of 3577 European American women (966 PTSD cases and 2611 trauma-exposed controls). We applied a high-resolution polygenic score approach and Mendelian randomization analysis to investigate genetic correlations and causal relationships.

Results

We observed an inverse association of PTSD with genetically determined anthropometric traits related to body shape, independent of body mass index (BMI). The top association was related to BMI-adjusted waist circumference (WC_adj; R = –0.079, P < 0.001, Q = 0.011). We estimated a relative decrease of 64.6% (95% confidence interval = 27.5–82.7) in the risk of PTSD per 1-SD increase in WC_adj. MR-Egger regression intercept analysis showed no evidence of pleiotropic effects in this association (P_pleiotropy = 0.979). We also observed associations of genetically determined WC_adj with age at first sexual intercourse and number of sexual partners (P = 0.013 and P < 0.001, respectively).

Conclusions

There is a putative causal relationship between genetically determined female body shape and PTSD, which could be mediated by evolutionary mechanisms involved in human sexual behaviors.

Electronic supplementary material

The online version of this article (doi:10.1186/s13073-017-0491-4) contains supplementary material, which is available to authorized users.

Sexual Orientation Disparities in Mistimed and Unwanted Pregnancy Among Adult Women

CONTEXT

Many sexual minority women, regardless of sexual identity, engage in heterosexual behavior across the life course, which provides them opportunities to experience an unintended pregnancy. In addition, sexual minority women are more likely than others to report characteristics that may make them vulnerable to unintended pregnancy. Little research, however, has examined whether the risk of unintended pregnancy is elevated among these women.

METHODS

Using data from the 2006-2010 National Survey of Family Growth, logistic regression models were fitted to examine sexual orientation disparities in mistimed and unwanted pregnancies among 9,807 women aged 20-45; mixed-effects hazard models assessed disparities in the intention status of 5,238 pregnancies among these women by maternal sexual orientation.

RESULTS

Compared with heterosexual women reporting only male partners, heterosexual women who have sex with women had higher odds of reporting a mistimed pregnancy (odds ratio, 1.4), and bisexual women had higher odds of reporting an unwanted pregnancy (1.8). When compared with pregnancies reported by heterosexual women with only male partners, those reported by heterosexual women who have sex with women were more likely to be mistimed (hazard ratio, 1.7), and those reported by bisexual and lesbian women were more likely to be unwanted (1.7-4.4).

CONCLUSIONS

Compared with heterosexuals who have sex with men only, adult sexual minority women are at equal or greater risk of reporting an unintended pregnancy. More research addressing the reproductive health care needs of sexual minority women is needed to develop strategies to improve family planning for this population.

Disclosure bias for group versus individual reporting of violence amongst conflict-affected adolescent girls in DRC and Ethiopia

Methodologies to measure gender-based violence (GBV) have received inadequate attention, especially in humanitarian contexts where vulnerabilities to violence are exacerbated. This paper compares the results from individual audio computer-assisted self-administered (ACASI) survey interviews with results from participatory social mapping activities, employed with the same sample in two different post-conflict contexts. Eighty-seven internally displaced adolescent girls from the Democratic Republic of the Congo and 78 Sudanese girls living in Ethiopian refugee camps were interviewed using the two methodologies. Results revealed that the group-based qualitative method elicited narratives of violence focusing on events perpetrated by strangers or members of the community more distantly connected to girls. In contrast, ACASI interviews revealed violence predominantly perpetrated by family members and intimate partners. These findings suggest that group-based methods of information gathering frequently used in the field may be more susceptible to socially accepted narratives. Specifically, our findings suggest group-based methods may produce results showing that sexual violence perpetrated by strangers (e.g., from armed groups in the conflict) is more prevalent than violence perpetrated by family and intimate partners. To the extent this finding is true, it may lead to a skewed perception that adolescent GBV involving strangers is a more pressing issue than intimate partner and family-based sexual violence, when in fact, both are of great concern.

Care of the Adolescent After an Acute Sexual Assault

Sexual violence is a broad term that encompasses a wide range of sexual victimizations. Since the American Academy of Pediatrics published its last policy statement on sexual assault in 2008, additional information and data have emerged about sexual violence affecting adolescents and the treatment and management of the adolescent who has been a victim of sexual assault. This report provides new information to update physicians and focuses on the acute assessment and care of adolescent victims who have experienced a recent sexual assault. Follow-up of the acute assault, as well as prevention of sexual assault, are also discussed.

Acute Sexual Assault in the Pediatric and Adolescent Population

Children and adolescents are at high risk for sexual assault. Early medical and mental health evaluation by professionals with advanced training in sexual victimization is imperative to assure appropriate assessment, forensic evidence collection, and follow-up. Moreover, continued research and outreach programs are needed for the development of preventative strategies that focus on this vulnerable population. In this review we highlight key concepts for assessment and include a discussion of risk factors, disclosure, sequelae, follow-up, and prevention.

Patterns of Service Utilization Among Pregnant and Parenting African American Adolescents

This study explored factors associated with differential patterns of social and health service use among pregnant and parenting African American adolescents. One hundred seventy-seven young women between the ages of 14 and 22 took part in the study. Cluster analysis suggested three groups of users: frequent users, moderate users, and inconsistent users. These groups were distinct in terms of their frequency of service usage, perceptions of barriers to usage, and psychological and social functioning. Moderate users appeared to be healthier than either the frequent or inconsistent users, as indicated by their relatively higher levels of psychological functioning. In contrast, inconsistent users were distinguished by their high rates of sexual victimization, their low use of medical services, and their perceptions of many programmatic and personal barriers to usage. Suggestions for research and interventions that encompass the diverse needs of young African American women are made.

Teen Parents and Academic Success

The purpose of this study was to explore the personal life stories of women who became mothers while still in their teen years. The focus was on themes that evolved as important in the lives of these women, including family support, partner support, mentor support, economic opportunity, resiliency, optimism, and spirituality. Each of the 22 women in the study offered her formulas for success that are useful for consideration by school nurses. Factors the women perceived to contribute to their success in achieving a master’s or doctoral degree are explored. This study helps to identify the support and community efforts necessary to improve the outcome for teen mothers today. Their unique stories are exemplars of resiliency and achievement.

Unintended Pregnancy, Depression, and Hazardous Drinking in a Community-Based Sample of Sexual Minority Women

CONTEXT

Unintended pregnancy is a stressful life event with important implications for women's health. Little research has examined sexual minority women's (SMW; lesbian, bisexual, mostly heterosexual) experiences of unintended pregnancy, and no studies have examined the relationship between unintended pregnancy, mental health, and negative coping behaviors in this population.

METHODS

We used the Chicago Health and Life Experiences of Women (CHLEW) Study (n = 454), a diverse sample of SMW, to examine the relationship between self-reported unintended pregnancy, depressive symptoms, and hazardous drinking. We used generalized linear model-building techniques and adjusted for key sociodemographic controls, as well as unintended pregnancy risk factors, including childhood physical and sexual abuse and age of sexual debut.

RESULTS

Twenty-four percent of the sample reported an unintended pregnancy. SMW who reported unintended pregnancies also reported significantly more depressive symptoms and greater risk of hazardous drinking. Adjusting for childhood abuse explained the relationship between unintended pregnancy and depressive symptoms, but not the relationship between unintended pregnancy and hazardous drinking.

CONCLUSIONS

Unintended pregnancy among SMW is an understudied topic. Our results suggest that unintended pregnancy is not uncommon among SMW and highlight the need for more research to investigate the mechanisms that link unintended pregnancy to depression and to hazardous drinking within this population.

An evaluation of the current state of sexual and reproductive health and rights of women in Ghana

OBJECTIVE

To provide a current account of women's sexual and reproductive health and rights (SRHR) in Ghana (West Africa), a priority area in achieving the World Health Organization's Millennium Development Goals.

METHOD

The study was observational. Three-hundred ninety Ghanaian women attending cervical cancer screening were surveyed about their SRHR. The data were analyzed with chi-squared test (p ≤ 0.05, two-sided).

RESULTS

22.1% had a life-time history of non-consensual sexual experience and 55.4% a previous history of abortion, mostly using services of a registered clinic (68.5%). Experience of sexual violence increased life-time risk of abortion (p = 0.018). The overall use of contraceptives was high (>60%); however, condom use during sexual intercourse with a new partner was low (23%), even among the highly educated women (32.7%) and women who stated to have received information on the risks and benefits of condom use (26.0%). Although condom use among the highly educated women was low, it was still 2 times higher than among the lower educated women, 15.7% (p < 0.001). There was also less condom use among the women with multiple sexual partners compared to single-partnered women (p = 0.001).

CONCLUSION

More than a decade after the inception of the Millennium Development Goals, there is still work to be done in Ghana, especially on education and sexual violence.

The Global Health Burden Of Rape

Women's rights to be free from male violence are now recognized by the United Nations as fundamental human rights. Two parallel transformations in the understanding of rape have been central to the international effort to achieve this declaration. The first is increased recognition of the extent to which rape typically involves intimates. The second is the shift from regarding rape as a criminal justice matter towards an appreciation of its implications for women's health. The focus of this paper is the health burden of rape, which is addressed from the global perspective and includes discussion of its prevalence and psychological, sociocultural, somatic, and reproductive health consequences. Quantitative efforts to capture the relative economic impact of rape compared to other threats to women's health are also discussed. The paper concludes with an agenda for future research on rape that could enrich activists' efforts on behalf of women's health and development.

[Sexual Abuse and Neglect Situations as Risk Factors for Adolescent Pregnancy]

BACKGROUND

In Colombia, one out of five women between the ages of 15 and 19 years have been pregnant. Almost two-thirds (64%) of these pregnancies were unplanned.

OBJECTIVES

To examine the socio-demographic, psychosocial and clinical risk factors associated with adolescent pregnancy.

METHODS

An analytical prevalence study was performed using secondary data from the First Demographic Study of Mental Health in Medellin, Colombia. Female adolescents between 13 and 19 years of age were included in the study. The population was evaluated using the Composite International Diagnosis Interview, a structured interview developed by the World Health Organization, which establishes diagnoses according to the DSM-IV and ICD-10 criteria.

RESULTS

A sample of 499 female adolescents was obtained, in which 135 adolescent pregnancies were identified, representing a prevalence of 21.5%. The large majority (84.4%) were between 16 and 19 years old. The median age was 17 years, with an interquartile range of 2 years. Almost two-thirds (61.2%) of female adolescents had initiated sexual activity at the age of 15 or later. Almost one-third (31.9%) reported being physically abused during childhood, and 6.7% sexually abused. Of those who were pregnant, 66.7% reported previous sexual abuse. A bivariate analysis showed that sexual abuse (OR=7.68), childhood negligence (OR=4.33), and having a partner (OR=6.31) were factors associated with an adolescent pregnancy.

CONCLUSIONS

Negligence and sexual abuse in childhood and adolescence can be prevented, and adolescent pregnancies can be decreased. This finding has important implications for clinical management and prognosis, and requires public preventive policies.

Risk of Sexual Violence: Perspectives and Experiences of Women in a Hospital in the Democratic Republic of Congo

Sexual violence in conflict situations is gaining worldwide recognition as a human rights issue. There is growing awareness and concern about the risks associated with sexual violence against women. This study was conducted in order to explore the perceptions and experiences of the risk of sexual violence in the Democratic Republic of Congo. The study draws on qualitative, in-depth interviews with women at a hospital in Bukavu. The findings show that women suffered humiliation, torture and beatings during their rape. Most women were raped by a number of men and others were forced to have sex with close family members. The rapist often used extreme brutality against the women which had major long-term consequences for women including unwanted pregnancies and/or HIV/AIDS. Many of the women experienced great uncertainty about their future and that of their children.

The role of specific early trauma in adult depression: A meta-analysis of published literature. Childhood trauma and adult depression

BACKGROUND

A large literature has long focused on the role of trauma in childhood and risk for psychological disorders in adulthood. Despite several studies performed, to date, it is not clear which weight have different childhood stressors specifically on the risk for depression in adult life. In the present study, we performed a meta-analysis of the literature in order to assess the effective role of childhood traumas as risk factor in the onset of depressive disorders in adults.

METHODS

Previously published papers investigating the exposure to childhood trauma and their association with depression in adult subjects were retrieved in literature through common databases. Meta-analysis was conducted by the RevMan software. The quality of studies was evaluated by an adapted version of the New-Ottawa Quality Assessment Scale; bias publication was evaluated by the Egger's test. Meta-regression analysis was employed to detect potential confounders and/or moderating variables. Finally, a sensitivity analysis was post-hoc performed to control for potential confounders.

RESULTS

Emotional abuse showed the strongest association with depression (OR=2.78) followed by neglect (OR=2.75) and sexual abuse (OR=2.42). Significant associations were also found for domestic violence (OR=2.06) and physical abuse (OR=1.98). Nevertheless, in post-hoc analysis, emotional abuse and neglect showed the strongest associations with depression as compared to other kinds of child trauma.

CONCLUSIONS

These findings support the role of neglect and emotional abuse as significantly associated to depression. Sexual/physical abuse or violence in family may be unspecific risk factors for mental disturbance. Other kind of trauma may play a less relevant role in risk of adult depression, though they should be not underestimated.

Associations between mental health, substance use, and sexual abuse experiences among Latinas

This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18-34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues.

The intergenerational transfer of mother-daughter risk for gender-based abuse

In this 10-year longitudinal study 150 mother-daughter pairs were recruited to participate in a study examining gender-based abuse across three generations. Forms of gender-based abuse included: child sexual abuse, witnessing intimate partner violence against their mothers, and intimate partner violence or dating violence in adolescence or adulthood. Daughters were interviewed when they were on average 9, 14, and 16 years old. Regression analyses revealed that if the grandmother (G1) was abused by her husband, her daughter (G2) was more likely to be sexually molested in childhood and was also more likely to be in an abusive relationship as an adult. If the mother (G2) was sexually abused as a child her daughter (G3) was at increased risk for child sexual abuse. In turn, child sexual abuse for the daughters related to their reports of dating violence in adolescence. Daughters (G3) who were sexually abused expressed more anxiety about romantic relationships, reflecting early attachment conflicts. Both child sexual abuse and anxious romantic attachment style independently predicted adolescent sexual risk-taking as in having multiple sexual partners or dating older men. These findings demonstrate how informative it is to include multiple forms of gender-based abuse in research and practice to better illuminate complex family dynamics. In addition, the findings support previous empirical work showing the importance of attachment behavior in women who are in abusive relationships, which has unique clinical implications.

The smart life

The Smart Life is an approach conceptualized from a frame of prevention, focused on youth, and aimed toward fostering independent and productive life styles. Currently, the focal concern is on African American youths, ages 12 through 18, who reside in rural areas of North Central Florida. Implemented through seminars, the Smart Life approach is grounded in theory and practice. It is built on grass roots efforts directed toward enlightening youths about the ways to improve their future through formulating goal-directed plans, and awakening their abilities to realize healthy and productive lives. The theoretical framework encompasses both Erik Erikson's psychoanalytic theory of identity development and the life cycle, as it accentuates the psychosocial nature of identify formation during adolescence, and Albert Bandura's social learning theoretical formulations specific to self-efficacy in terms of perceived self-competence.The seminars, held in various community-based settings, cover several areas. The issue to identity is always addressed. Discussions include: the meaning of being an African American, information on the history and global locations of people of African descent, and encouragement to make attachments. The other 4 critical areas that The Smart Life seminars focus on include the prevention of: crime and violence, early sexual experiences and pregnancy, alcohol and drug use and abuse, and school failure.

Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy

OBJECTIVE

Pregnant adolescents have high rates of poor birth outcomes, but the causes are unclear. We present a prospective, longitudinal study of pregnant adolescents assessing associations between maternal psychobiological stress indices and offspring gestational age at birth and birthweight.

METHOD

Healthy nulliparous pregnant adolescents were recruited (n=205) and followed during pregnancy. Ambulatory assessments over 24h of perceived psychological stress (collected every 30 min) and salivary cortisol (6 samples) and a summary questionnaire, the Perceived Stress Scale, were collected at three time points (13-16, 24-27, and 34-37 gestational weeks). Corticotropin-releasing hormone, C-reactive protein, and interleukin 6 were assayed from blood taken at the latter 2 sessions. A final sample of 119 participants was selected for analyses.

RESULTS

The ambulatory assessment of perceived psychological stress was positively correlated with the Perceived Stress Scale (r=.20, p=.03) but neither was associated with any of the biological assays (all ps>.20). Based on backward selection regression models that included all stress variables and relevant covariates, the ambulatory assessments of perceived psychological stress and cortisol - though not the Perceived Stress Scale - were negatively associated with gestational age at birth (F(4, 107)=3.38, p=.01) while cortisol was negatively related to birthweight (F(5, 107)=14.83, p<.0001).

CONCLUSIONS

Targeted interventions to reduce psychological and biological indicators of heightened stress during pregnancy may have positive public health benefits for the offspring given the associations of shortened gestation and lower birthweight with risk for poor mental and physical health outcomes.

Assessment of sexual violence among street females in Bahir-Dar town, North West Ethiopia: a mixed method study

Background

Sexual violence is a major public health concern as well as human rights violation. Homeless women are far more likely to experience violence of all sorts than women in general. The objective of this study is to assess the prevalence and consequence of rape, and explore the reasons and factors associated with rape among street females in Bahir-Dar town, North West Ethiopia.

Methods

This is a mixed method study which included: a survey of 395 street females age 15 – 49; key informant interview with 4 stakeholders; 5 case studies; one focus group of 10 street females and one focus group of 10 street males. Street females are those who spend most of their time on the street and who depend on the street for their life. Qualitative and quantitative data were assessed separately with thematic and statistical analysis respectively. Quantitative data was analyzed using SPSS version 16.0. Bivariate and Multivariate analysis were determined.

Results

Life time prevalence of rape was 24.3% and the prevalence of rape in the last year was 11.4%. Factors like females “off” the street [OR (95% CI) =6.2 (3.0, 12.9)], being a prostitute [OR (95% CI) = 4.1 (1.5, 11.1)] and age 15–29 [OR (95% CI) =3.5 (1.1, 11.2)] were significantly associated with rape. Most, 93.8% of the rapes were not reported to legal bodies. None of the victims used condom during the rape event. Only, 4 (4.2%) of the victims used emergency contraceptive method following the rape event. Out of the total of 96 victims of rape, 13 (19.1%) and 9 (13.2%) experienced unwanted pregnancy and induced abortion respectively. Beside, 38 (41%) and 15 (22%) victims claimed genital injury and unusual vaginal discharge respectively. Psychological consequence like, hating others by 34 (35.8%), fear and concern for HIV/AIDS by 44 (46.6%), guilt feeling by 28 (29.4%) and loss of interest in sexual activity by 28 (29.4%) of victims were reported. Majority, 42.9% of victims attribute their victimization with sleeping in areas where there are many brothels. Being physically weak, long stay in street life, and sleeping around street males were reasons mentioned for rape by 11.9%, 29.7% and 15.4% of rape victims respectively.

Conclusion

In general, there is a very high prevalence of rape exacting significant physical and psychological tolls in victims of the study. Therefore, timely and integrated actions of the various stakeholders working in this area are crucial to curtail this critical human rights violation.

Using qualitative inquiry and participatory research approaches to develop prevention research: validating a life course perspective

Application of life course theory (LCT) holds promise for advancing knowledge toward the elimination of health disparities. This article validates the usefulness of employing a life course perspective when conducting health disparities research. We provide an overview of LCT as it applies to our research program in prevention of human immunodeficiency virus (HIV) among Latino teen parents. We illustrate the goodness-of-fit of our research with the basic premises of LCT. Though early adverse life experiences impact health over the lifespan, strength-based HIV prevention programs designed for Latino teen parents that recognize the reality of their lives may alter their health trajectory.

The reporting of maltreatment experiences during the Adult Attachment Interview in a sample of pregnant adolescents

This present student examines maltreatment experiences reported by 55 high-risk pregnant adolescents in response to a slightly adapted version of the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996 ). Previous research has suggested that the rates of unresolved states of mind regarding trauma in response to the AAI may be underestimated due to the lack of direct questions and associated probes regarding physical, sexual, and emotional abuse. We address this concern by including behaviorally phrased questions and probes regarding maltreatment experiences into the original format of the AAI and examine the concordance between reports of maltreatment experiences in response to the AAI and the Childhood Trauma Questionnaire (CTQ). Maltreatment experiences in response to the AAI were evaluated using the Maltreatment Classification Scale developed by Barnett, Manly, and Cicchetti (1993). We also examine the association between unresolved states of mind and dissociation using the Adolescent Dissociative Experience Scale. Results revealed a significant concordance between reports of maltreatment in response to the AAI and CTQ measures. Reports of maltreatment were prevalent in this sample: across the AAI and CTQ measures, 96% of pregnant adolescents reported some form of emotional abuse, 84% physical abuse, 59% sexual abuse, and 88% reported neglect. Sexual abuse history uniquely predicted unresolved status in response to the AAI. Self-reports of dissociation were significantly associated with unresolved states of mind. Results suggest that the inclusion of behaviorally focused questions and probes regarding maltreatment in the AAI protocol can further contribute to the clinical and theoretical value of this tool.

Childhood sexual abuse and sexual risks among young rural-to-urban migrant women in Beijing, China

BACKGROUND

Child sexual abuse (CSA) has substantial impact on women. The current study aims to explore the patterns of CSA in migrant women in China. Moreover, a relationship between experience of CSA and increased sexual risks was also examined among this vulnerable population.

METHODS

A final sample of 478 rural-to-urban migrant women was recruited from different work places in two urban districts of Beijing, China.

RESULTS

About 17% (n=80) of migrant women reported ever experienced any kind of CSA before 16 years of age. Participants who had multiple sexual partners, drank before sex and had early age of sexual debut reported higher rate of overall CSA (45.7% vs. 23%, p<0.01; 41.2% vs. 24%, p<0.05; and 47.8% vs. 24.4%, p<0.05) and contact CSA (37.1% vs. 15.6%, p<0.01; 32.4% vs. 16.8%, p<0.05; and 39.1% vs. 17%, p<0.05) compared to their counterparts. The multivariate analysis confirmed the results of bivariate analysis that a history of CSA was associated with increased sexual risks in adulthood.

CONCLUSION

The current study suggests that health-related prevention intervention programs (i.e., HIV-related sexual risks prevention intervention) targeting the migrant women population needs to take in consideration the possible experience of CSA. Moreover, effective school-based or community-based CSA prevention intervention should be conducted to reduce CSA rate and improve attention to CSA issues in rural communities in China.

Sexual abuse in childhood and adolescence and the risk of early pregnancy among women ages 18-22

PURPOSE

This clinic- and community-based study of young women investigated the relationship between previous sexual abuse and early pregnancy, examining the effect of the developmental period in which sexual abuse occurred and type of sexual abuse, while also providing methodological advances in the assessment of distinctive sexual abuse and its sequelae.

METHODS

Secondary data analysis using Cox proportional hazards models was conducted to determine the association between sexual abuse in childhood, in adolescence, or both, and risk of early pregnancy among 1,790 young women. In addition, this study examined the type of sexual abuse that occurred during each period.

RESULTS

As compared with women with no history of sexual abuse, women who experienced sexual abuse only in childhood had a 20% greater hazard of pregnancy; women who experienced sexual abuse only in adolescence had a 30% greater hazard of pregnancy; and women who experienced sexual abuse in both childhood and adolescence had an 80% greater hazard of pregnancy. Across these periods, attempted rape and rape were associated with an increased hazard of pregnancy. The association between sexual abuse and pregnancy was mediated by age at first intercourse and moderated by a woman's education level.

CONCLUSION

This study provides evidence that both the developmental timing and the type of sexual abuse contributes to an increased risk for early pregnancy. The study findings indicate that sexual abuse leads to an earlier age of first sexual intercourse, which in turn increases the likelihood of an early pregnancy. Women with higher educational attainment are less likely to experience early pregnancy as a result of abuse.

Impact of timing of sex education on teenage pregnancy in Nigeria: cross-sectional survey of secondary school students

The objective of this study was to explore whether the time at which sex education was provided had any impact on reported cases of unintended pregnancies. A cross-sectional survey of secondary school students and their teachers was conducted using self-administered questionnaires. The participants were 1,234 students aged 14-17 years and 46 teachers in 5 secondary schools in South Eastern Nigeria. The outcome measures were reported pregnancies within the last 3 years by type of school and class level; class level at the time of receiving sex education at school; and age at the time of receiving sex education at home. In all schools, sex education was provided at all the junior and senior secondary school levels (JSS and SSS, respectively). Overall, reported cases of unintended pregnancies were highest among the junior students. In the private schools, four in ten teachers reported pregnancies among JSS 3 students. Almost four in ten teachers in public schools reported pregnancies among JSS 2 students. Of all the students, about three in ten reported pregnancies among JSS 2 and 3 students respectively. At home, sex education was provided at the mean age of 16 years (SD ± 2.2). All participants cited financial need and marital promise as major predisposing factors. About four in ten students did not use contraceptives during their first sexual experience. This study highlights the need to introduce sex education much earlier, possibly before the JSS levels. At home, sex education may have greater impact if provided before the age of 14 years. Efforts should be made to address the factors predisposing to teenage pregnancy.

Sexual Violence Victimization of Women

Sexual violence is a serious public health problem with devastating health-related consequences. In this article, the authors review the prevalence, characteristics, vulnerability factors for, and impacts of sexual violence victimization for women. Some key factors are reviewed that have been shown to increase vulnerability for victimization, including certain demographic characteristics, previous victimization, and use of drugs or alcohol. The impacts of rape and other sexual violence are described, including physical and sexual health; psychological, social, and societal impacts; as well as impact on risky health behaviors. The authors conclude with a discussion of the public health approach to sexual violence, primary prevention, the relevance of sexual violence research for health care practitioners, and recommendations for health care practice.

A global perspective on child sexual abuse: meta-analysis of prevalence around the world

Our comprehensive meta-analysis combined prevalence figures of childhood sexual abuse (CSA) reported in 217 publications published between 1980 and 2008, including 331 independent samples with a total of 9,911,748 participants. The overall estimated CSA prevalence was 127/1000 in self-report studies and 4/1000 in informant studies. Self-reported CSA was more common among female (180/1000) than among male participants (76/1000). Lowest rates for both girls (113/1000) and boys (41/1000) were found in Asia, and highest rates were found for girls in Australia (215/1000) and for boys in Africa (193/1000). The results of our meta-analysis confirm that CSA is a global problem of considerable extent, but also show that methodological issues drastically influence the self-reported prevalence of CSA.

Child maltreatment and the transition to adult-based medical and mental health care

BACKGROUND

Child maltreatment is a public health problem with lifelong health consequences for survivors. Each year, >29 000 adolescents leave foster care via emancipation without achieving family permanency. The previous 30 years of research has revealed the significant physical and mental health consequences of child maltreatment, yet health and well-being have not been a priority for the child welfare system.

OBJECTIVES

To describe the health outcomes of maltreated children and those in foster care and barriers to transitioning these adolescents to adult systems of care.

METHODS

We reviewed the literature about pediatric and adult health outcomes for maltreated children, barriers to transition, and recent efforts to improve health and well-being for this population.

RESULTS

The health of child and adult survivors of child maltreatment is poor. Both physical and mental health problems are significant, and many maltreated children have special health care needs. Barriers to care include medical, child welfare, and social issues. Although children often have complex medical problems, they infrequently have a medical home, their complex health care needs are poorly understood by the child welfare system that is responsible for them, and they lack the family supports that most young adults require for success. Recent federal legislation requires states and local child welfare agencies to assess and improve health and well-being for foster children.

CONCLUSIONS

Few successful transition data are available for maltreated children and those in foster care, but opportunities for improvement have been highlighted by recent federal legislation.

Sexual coercion of married women in Nepal

BACKGROUND

Sexual coercion is an important public health issue due to its negative association with social and health outcomes. The paper aims to examine the prevalence of sexual coercion perpetrated by husbands on their wives in Nepal and to identify the characteristics associated with this phenomenon.

METHODS

The data used in this paper comes from a cross-sectional survey on "Domestic Violence in Nepal" carried out in 2009. A total of 1,536 married women were interviewed and associations between sexual coercion and the explanatory variables were assessed via bivariate analysis using Chi-square tests. Logistic regression was then applied to assess the net effect of several independent variables on sexual coercion.

RESULTS

Overall, about three in five women (58%) had experienced some form of sexual coercion by their husbands. Logistic regression analysis found that the literacy status of women, decision-making power regarding their own health care, husband-wife age differences, alcohol consumption by the husband, and male patriarchal control all had significant associations with women's experience of sexual coercion. Literate women had 28% less chance (adjusted odds ratio (aOR) = 0.72) of experiencing sexual coercion by their husbands than did illiterate women. Women who made decisions jointly with their husbands with regard to their own health care were 36% less likely (aOR = 0.64) to experience sexual coercion than those whose health care was decided upon by their mothers/fathers-in-law. On the other hand, women whose husbands were 5 or more years older than they were more likely to report sexual coercion (aOR = 1.33) than were their counterparts, as were women whose husbands consumed alcohol (aOR = 1.27). Furthermore, women who experienced higher levels of patriarchal control from their husbands were also more likely to experience sexual coercion by their husbands (aOR = 7.2) compared to those who did not face such control.

CONCLUSION

The study indicates that sexual coercion among married women is widespread in Nepal. Programs should focus on education and women's empowerment to reduce sexual coercion and protect women's health and rights. Furthermore, campaigns against alcohol abuse and awareness programs targeting husbands should also focus attention on the issue of sexual coercion.

Childhood sexual abuse and adult sexual health among indigenous Kanak women and non-Kanak women of New Caledonia

OBJECTIVES

Few studies have addressed the long-term consequences of adverse childhood experiences among women in Oceania, in particular among indigenous women. This paper aims to report prevalences of childhood sexual abuse (CSA) and to asses the negative sexual health consequences in adulthood by comparing indigenous Kanak to non-Kanak women in New Caledonia.

METHODS

Data come from a population survey on violence against women and health. Face-to-face interviews were conducted in 2002-2003 with adult women randomly selected from the electoral list. Separate models for Kanak (n=329) and non-Kanak women (n=426) were performed. Regression models adjusted for relevant socio-demographics factors were conducted to estimate the odds ratios for the associations between childhood sexual abuse and adult sexual health outcomes.

RESULTS

A non-significant difference between Kanak (11.8%) and non-Kanak women (14.4%) was found for the prevalence of CSA. Among Kanak women, CSA increases the risk of sexually transmitted infections, of non-desired sexual intercourse with an intimate partner and of experience of adult sexual violence. However, use of modern contraception as an adult was more frequent among CSA Kanak victims, as compared to other Kanak women. Among non-Kanak women, only abortion appeared significantly associated with CSA.

CONCLUSIONS AND PRACTICE IMPLICATIONS

The findings show that in all ethnic communities of New Caledonia, a history of child sexual abuse is not rare among women. They also shed light on the long-term consequences of CSA, suggesting that the effect of CSA may differ according to ethnic membership and subsequent social stratification and gender norms. Efforts to break the silence around violence against girls and establish a stronger foundation are required in New Caledonia. Prevention programs on violence against women and sexual health that take into account the cultural and social heterogeneity are needed.

Reflections of Native American teen mothers

OBJECTIVE

To understand the previously lived experience of early childbearing among adult Native American women.

DESIGN

A community-based participatory research approach.

SETTING

The first interview took place at a mutually agreed-upon time and place and averaged 120 minutes. Second interviews were conducted 1 to 3 months later.

PARTICIPANTS

A convenience sample of 30 self-identified Native American adult women was recruited, and a semistructured interview explored their early childbearing experiences.

METHOD

An interpretive phenomenological study was conducted with a Northwestern tribe.

RESULTS

All of the women in the study described stressful childhoods. Two primary themes were identified: Chaotic childhoods represented stressful events in youth that introduced or resulted in ongoing chaos in women's lives and diminished childhoods described early maturity as a result of assuming extensive responsibilities at a young age.

CONCLUSIONS

The findings suggest that the childhood experiences described by participants may be related to the risk for early childbearing. Prospective research should examine the relationship between young women's lives and early childbearing to design interventions to support them in postponing pregnancy and when they do become pregnant.

Natural Mentoring Relationships among Adolescent Mothers: A Study of Resilience

This study focused on natural mentoring relationships between nonparental adults and African American adolescent mothers. Data were collected from 93 adolescent mothers over five time points, starting in the adolescent mothers' senior year of high school and ending five years post-high school. We found that having a natural mentor was related to fewer depressive symptoms and fewer anxiety symptoms over time. Natural mentor presence also modified the relationship between stress and mental health problems over time. Facilitating these natural mentoring relationships between adolescent mothers and nonparental adults may be a useful strategy for promoting healthy development within this population.

Prevalence and risk factors for adult paternity among adolescent females ages 14 through 16 years

To investigate sociodemographic factors associated with adolescent females ages 14-16 years having children fathered by males age 20 years or older and identify differences in correlates across rural, urban, and border areas. The method section was a cross-sectional study using Texas birth record data. From 2000 through 2004, there were 29,186 births to adolescent females aged 14-16 years with valid paternal age. Prevalence of and adjusted odds of paternal age of 20 years or older were identified by paternal and maternal factors. The Results section Having both parents born outside of the U.S. was associated with a 5.29 (95% CI: 4.82, 5.80) times increase in the odds of paternal age of 20 years or older as compared to having both parents born in the U.S. Parental place of birth was associated with greater odds of paternal age of 20 years or older in urban areas compared to rural or border areas. Compared to those with average or high educational attainment relative to age, low educational attainment relative to age was associated with an increase in the odds of paternal age of 20 years or older. This association was present whether maternal or paternal educational attainment was low relative to age. Messages are needed to help adolescent females avoid pregnancy with adult males. In addressing this specific prevention challenge, it is important to consider maternal/paternal place of birth and its association with adolescent births with adult males.

Sexual intercourse among adolescents maltreated before age 12: a prospective investigation

OBJECTIVE

To examine whether child maltreatment (physical, emotional, and sexual abuse, and neglect) predicts adolescent sexual intercourse; whether associations between maltreatment and sexual intercourse are explained by children's emotional distress, and whether relations among maltreatment, emotional distress, and sexual intercourse differ according to gender.

METHODS

The Longitudinal Studies of Child Abuse and Neglect was a multisite, longitudinal investigation. Participants ranged from at-risk to substantiated maltreatment. Maltreatment history was assessed through Child Protective Service records and youth self-report at age 12. Youth reported emotional distress by using the Trauma Symptom Checklist at the age of 12 years and sexual intercourse at ages 14 and 16. Logistic and multiple regressions, adjusting for gender, race, and site, were used to test whether maltreatment predicts sexual intercourse, the explanatory effects of emotional distress, and gender differences.

RESULTS

At ages 14 and 16, maltreatment rates were 79% and 81%, respectively, and sexual initiation rates were 21% and 51%. Maltreatment (all types) significantly predicted sexual intercourse. Maltreated youth reported significantly more emotional distress than non-maltreated youth; emotional distress mediated the relationship between maltreatment and intercourse by 14, but not 16. At 14, boys reported higher rates of sexual intercourse than girls and the association between physical abuse and sexual intercourse was not significant for boys.

CONCLUSIONS

Maltreatment (regardless of type) predicts sexual intercourse by 14 and 16. Emotional distress explains the relationship by 14. By 16, other factors likely contribute to intercourse. Maltreated children are at risk for early initiation of sexual intercourse and sexually active adolescents should be evaluated for possible maltreatment.

Prevalence of sexually abusive experiences in childhood and adolescence among a community sample of Latinas: a descriptive study

This study examined the prevalence, severity, and circumstances of self-reported sexually coercive and abusive experiences in childhood and adolescence in a community sample of Latina women (N=204) ages 18 to 34 years. Results from structured phone interviews indicated that 35% of the women reported experiencing some form of sexual abuse, 31% of the reported perpetrators were family members, and 52% were boyfriends, friends, or acquaintances. Of those who reported an abusive experience, 44% had not disclosed the abuse to anyone; for those who did disclose, 74% reported feeling supported. Findings highlight the importance of including peer and dating-partner abuse in the assessment of CSA and the necessity for outreach to Latina women who may have never disclosed their experiences of abuse.