Purpose: To examine the association between history of childhood physical and sexual abuse and self-reported suicidal ideation (SI) and suicide attempts (SA) among 843 substance using women.

Methods: women recruited from two community based HIV prevention studies (NIAAA funded, Sister-to-Sister, and NIDA funded, Women Teaching Women).  The Computerized Diagnostic Interview Schedule assessed SI and SA. We stratified women into three groups: Both SI and SA (SISA+), either SI or SA (SI/SA) and, neither (SISA-). The Violence Exposure Questionnaire assessed physical and sexual abuse before age 15.

Findings: Women were predominantly African American (80%), and 35.7 years (± 8.8); 53% had no SI or SA, 27% had both SI and SA and 20% had either SI or SA. SISA + women were more likely than SI/SA and SISA- women to have ever drunk 20 or more drinks in one day (57% vs. 39% vs. 37% p<0.0001) and meet criteria for DSM-IV cocaine dependence (62% vs. 58% vs. 44% p<0.0001). Likewise, SISA+ women were more likely than SI/SA and SISA- women to report, being beaten severely by a parent/legal guardian before age 15 (22% vs. 8% vs. 4% p<0.0001), to be forced to have sex by someone (43% vs. 33% vs. 17% p<0.0001),  being forcibly kissed or touched by someone  (60% vs. 48% vs. 23% p<0.0001) or forced to kiss or touch someone against their will (49% vs. 39% vs. 17% p<0.0001).

Implications: Assessment of suicide risk among women with histories of childhood physical and sexual abuse is crucial for preventive interventions.