Childhood maltreatment, sexual risk behavior and sexually transmitted infections: Risk and resilience

Background: Childhood maltreatment is associated with adolescent and adult sexual risk behaviors and sexually transmitted infections (STI), including HIV, among black women living in the United States. Because of disproportionately high rates of STI/HIV among black females, it is important to examine how maltreatment during childhood adversely affects sexual risk behavior and STI outcomes during adolescence as well as its long-term effects during young adulthood. Protective influences during these periods were also examined. Methods: Data are from 1,552 sexually active black young adult women from the National Longitudinal Study of Adolescent Health (Waves I and III). Structural equation modeling was used to assess the impact of childhood maltreatment on adolescent and young adult individual characteristics (family attachment, depression, alcohol use, religiosity, sexual debut, and alcohol use) and ultimately on the number STI diagnoses and sexual risk behavior in young adulthood. Results: Childhood maltreatment negatively affects individual characteristics during adolescence and young adulthood. Further, it is directly and indirectly associated with young adult sexual risk behavior and STIs among young adult black women. Family attachment and religiosity were protective against sexual risk behavior, but not against STI diagnoses. Conclusion: Childhood maltreatment has negative long-lasting effects. Healthcare practitioners should assess young black women for histories of childhood maltreatment so that they and their families may obtain necessary care and counseling to prevent long-term consequences. Further study should address the roles of protective factors as family attachment and religiosity were found to be protective against sexual risk behavior but not STIs.