Childhood experience of abuse leads to higher lifetime STI prevalence among Ukrainian women

One health consequence of rapid economic, political, and social transformation in Ukraine is an increase in sexually-transmitted infections (STIs), including HIV. Ukraine has an estimated adult HIV prevalence rate of 1.4%, an HIV incidence rate among the highest in the world, and large epidemics of other sexually transmitted diseases, including syphilis and gonorrhea. Initially concentrated among intravenous drug users, the HIV virus is increasingly being transmitted via heterosexual intercourse, and new cases are concentrated almost entirely among adolescents and young adults aged 30 and under. In addition to increasing the transmission rate of HIV, untreated STIs can also lead to ectopic pregnancies, low birth weight, increased infant mortality, and infertility, all of which could exacerbate the very low Ukrainian birth rates and net population loss of the past few years. It is therefore important to understand factors leading to STI infections in Ukraine.

Previous research indicates a link between childhood experience of sexual and physical abuse and sexually transmitted infections, perhaps because abused adolescents debut sexually at earlier ages than non-abused adolescents. Using Reproductive Health Survey data from Ukraine, I show that adolescents and women abused as children are at higher lifetime risk of acquiring a sexually-transmitted infection (OR = 1.35, p < .000). I explore two pathways via which child abuse might affect adult STI risk in Ukraine. Firstly, adolescents who are abused as children debut sexually an average of 0.33 years earlier than non-abused girls. Older ages of sexual debut are strongly associated with lower probability of acquiring a lifetime STI (OR = 0.94, p < .000). Secondly, women abused as children are more likely to select into abusive relationships (OR = 3.23, p < .000) as adults, which are themselves significantly positively associated with STI risk.