Determining the influence of childhood physical and sexual violence on later health behaviors among young, urban women using ACASI

Exposure to childhood physical and sexual violence is particularly prevalent among young, urban African American women and is a major public health concern because of the resulting negative health behaviors and outcomes. This study examined the role of childhood exposure to violence and later adverse health behaviors using audio computer assisted survey instrument (ACASI).

The Young Women’s Health Study enrolled 315 young urban, sexually active women in 2013 during their visit to a family planning clinic in Philadelphia PA. The baseline ACASI interview collected information on childhood physical and sexual violence, recent marijuana use, current problem drinking, and current cigarette use.

We found 46.3% of young women reported childhood physical abuse (CPA), while 17.8% reported childhood sexual abuse (CSA). Women reporting at least one episode of CSA were significantly more likely to use marijuana (55.4% vs 38.6%, p-value 0.021) and smoke cigarettes (44.6% vs. 22.0%, p-value <0.001). Women reporting at least one episode of CPA were significantly more likely to report cigarette use (34.2% vs. 18.9%, p-value 0.02). Problem drinking was not related to CSA or CPA. CSA remained a significant predictor of marijuana use after adjusting for age, homelessness status, race, current depressive symptoms and education level (aOR=2.0, 95% CI: 1.1-3.8). Current depressive symptoms and age were also significantly related to marijuana use (aOR= 2.1, 95% CI: 1.3-3.5 and aOR= 0.9, 95% CI: 0.8-0.9).

Prevention interventions for young women seeking substance use treatment should recognize the role of CSA and CPA and long term behavioral consequences should be noted.