Impact of abuse history on adolescent African American females' current HIV/STD-associated behaviors and psychosocial mediators of HIV/STD risk

Background: The relationship between prior emotional, physical, or sexual abuse and later sexual risk behavior engagement and STI risk is unclear. Objective: To better understand this association, this study examined behavioral and psychosocial correlates of prior abuse among African American adolescents who were not currently in abusive relationships. Methods: 593 African-American adolescents (ages 14-20) were tested for STIs and completed ACASI interviews with measures of abuse history, demographics, psychosocial variables, sexual behaviors, and STI history prior to participating in an STD/HIV prevention trial. Bivariate and logistic regression analyses examined differences between those with an abuse history (emotional, physical, or sexual abuse) and individuals without prior abuse. Results: 58% reported an abuse history. Participants with an abuse history had slightly greater odds of reporting an STI history (OR: 1.4, 95% CI:1.0-1.9); no differences were found for current STI status. Participants with an abuse history were significantly (p<.001) more likely to report: sex while they and/or their partner were high on drugs or alcohol, older sexual partners, and recently incarcerated sexual partners. Participants who had been abused were also more likely to report greater condom negotiation fears (p=.003), less sex refusal self-efficacy (p<.001), and less relationship power (p=.006). Conclusions: A modest association between abuse history and STI status was observed. However, those with an abuse history were more likely to report riskier sexual partners and greater barriers to consistent condom use. Further research is needed to clarify the association between abuse history and subsequent sexual risk behavior engagement.