TY - JOUR
T1 - Adverse childhood experiences (ACEs) are associated with forced and very early sexual initiation among Black women accessing publicly funded STD clinics in Baltimore, MD
AU - Tsuyuki, Kiyomi
AU - Al-Alusi, Noor A.
AU - Campbell, Jacquelyn C.
AU - Murry, De Marjion
AU - Cimino, Andrea N.
AU - Servin, Argentina E.
AU - Stockman, Jamila K.
N1 - Funding Information:
This research was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (https:// www.nichd.nih.gov/) (R01HD077891-Jamila K. Stockman, Jacquelyn Campbell, and Kiyomi Tsuyuki; K23HD084756-Argentina E. Servin), the National Institute of Drug Abuse (https://www. drugabuse.gov) (K01DA031593-J.K. Stockman; T32DA023356-K. Tsuyuki), the National Institute on Minority Health and Health Disparities (https:// www.nimhd.nih.gov/) (L60MD003701-J.K. Stockman; L60MD011184-K. Tsuyuki), the National Institute of Alcohol Abuse and Alcoholism (https://www.niaaa.nih.gov/) (K01AA025009-K. Tsuyuki), and the University of California, San Diego Summer Training Academy for Research Success (STARS) program (http://grad.ucsd.edu/ diversity/programs/stars/index.html) (D. Murry). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the paper.
Publisher Copyright:
Copyright: © 2019 Tsuyuki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/5/6
Y1 - 2019/5/6
N2 - Purpose To examine the association between adverse childhood experiences (ACEs) and early sexual initiation. Methods 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. Results 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. Conclusions 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.
AB - Purpose To examine the association between adverse childhood experiences (ACEs) and early sexual initiation. Methods 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. Results 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. Conclusions 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.
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U2 - 10.1371/JOURNAL.PONE.0216279
DO - 10.1371/JOURNAL.PONE.0216279
M3 - Article
C2 - 31063469
AN - SCOPUS:85065758264
SN - 1932-6203
VL - 14
JO - PloS one
JF - PloS one
IS - 5
M1 - e0216279
ER -