Journal Article

Adverse childhood experiences (ACEs) are associated with forced and very early sexual initiation among Black women accessing publicly funded STD clinics in Baltimore, MD

Cimino, Andrea N., Stockman, Jamila K., Campbell, Jacquelyn C., Servin, Argentina E., Murry, DeMarjion, Tsuyuki, Kiyomi, Al-Alusi, Noor A.

2019

Overview

To examine the association between adverse childhood experiences (ACEs) and early sexual initiation. We analyzed retrospective data of (n = 241) Black women recruited from public STD clinics in Baltimore, MD. Multinomial logistic and linear regression models estimated associations between ACEs and early sexual initiation; contextual variables at initiation were examined as mediators. Twelve percent of our sample reported very early sexual initiation (11-12 years) and 29% reported early sexual initiation (13-14 years). Each additional ACE reported was associated with greater risk of very early sexual initiation (RRR = 1.49; 95%CI:1.23,1.80). Specifically, emotional abuse (RRR = 3.71; 95%CI:1.55,8.89), physical abuse (RRR = 9.45; 95%CI:3.56,25.12), sexual abuse (RRR = 8.60; 95%CI:3.29,22.51), witnessing maternal abuse (RRR = 5.56; 95%CI:2.13,14.52), and household substance misuse (RRR = 3.21; 95%CI:1.38,7.47) at or before the age of 18 were associated with very early sexual initiation. As for context of initiation, age at sexual initiation was younger if the man at initiation was a non-partner (ß = -0.88; 95%CI:-1.36,-0.40), was ≥3 years older (ß = -1.30; 95%CI:-1.82,-0.77), had pressured or forced sexual intitiation (ß = -1.09; 95%CI:-1.58,-0.59), and was under the influence of drugs/alcohol (ß = -0.97; 95%CI:-1.62,-0.32). Contextual variables at first sex, including being pressured or forced, and the man being ≥3 years older fully mediated the association between ACEs and early sexual initiation. This study highlights the critical need to develop interventions that reduce the impact of ACEs on women's health and delay age at sexual initiation. Health education efforts are needed for clinicians and parents to identify and prevent childhood abuse and to identify and report sexual coercion and abuse for girls and adolescents.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abuse / Acquired immune deficiency syndrome / Adolescent / Adolescent girls / Adolescents / Adult / Adults / Adverse Childhood Experiences / African American women / African Americans / Age / AIDS / Alcohol abuse / Alcohols / Baltimore / Biology and Life Sciences / Black people / Black women / Child / Child abuse / Child abuse & neglect / Child Abuse, Sexual - ethnology / Child Abuse, Sexual - psychology / Child development / Childhood / Childhood experiences / Childhood factors / Childhood trauma (Psychology) / Children / Clinics / Coercion / Context / Domestic violence / Drugs / Early childhood education / Emotional abuse / Female / Girls / Health aspects / Health disparities / Health education / HIV / Hospitals, Public / Human immunodeficiency virus / Humans / Infectious diseases / Influence / Mediation / Medical personnel training / Medicine / Medicine and Health Sciences / Mental disorders / Mental health / Nursing schools / Parents / People and Places / Physical Sciences / Public health / Regression analysis / Regression models / Reproductive health / Research and Analysis Methods / Retrospective Studies / Risk factors / Sex crimes / Sex education / Sexual abuse / Sexual assault / Sexual behavior / Sexual Behavior - ethnology / Sexual Behavior - psychology / Sexual coercion / Sexually Transmitted Diseases / Social Sciences / STD / Substance abuse / Survival analysis / Systematic review / Teenagers / Trauma / Variables / Women / Women's health / Womens health / Youth