Trajectories of Childhood Sexual Abuse and Early Adolescent HIV/AIDS Risk Behaviors: The Role of Other Maltreatment, Witnessed Violence, and Child Gender

Abstract

Childhood sexual abuse (CSA) has been associated with HIV/AIDS risk behavior; however, much of this work is retrospective and focuses on women. The current study used semi-parametric mixture modeling with youth (n = 844; 48.8% boys) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine the link between trajectories of CSA (2 to 12 years old) and HIV/AIDS risk behavior at age 14 (i.e., sexual intercourse & alcohol use). Trajectory analyses revealed a link between a history of CSA and the development of risky behavior. In addition, trajectories for physical and emotional abuse, but not neglect or witnessed violence, contributed to risky behavior over and above the role of CSA. Child gender did not moderate the findings. Findings highlight the signficance of CSA histories, as well as the broader context of maltreatment, for better understanding the development of risk behaviors in both girls and boys.

Funding for the current secondary analyses was provided by a Mentored Public Health Research Scientist Development Award awarded to the first author from the Centers for Disease Control and Prevention (K01PS000795-01). In addition to Drs. Desmond Runyan, Daniel Nagin, and Bobby Jones, who are mentors on the K01 and coauthors on this article, the first author extends her gratitude to Dr. Seth Kalichman, for his continued guidance in the field of HIV/AIDS prevention research and to Dr. Carol Runyan and the rest of her colleagues at the UNC Injury Prevention Research Center for thier continued guidance in the field of child maltreatment.

Funding for the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) is provided by grants from the National Center on Child Abuse and Neglect, the Children's Bureau, Office of Child Abuse and Neglect Administration on Children, Youth, and Families, the National Institute for Child Health and Human Development, and National Institutes of Health. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the funding agencies. We acknowledge all the LONGSCAN principal investigators, coordinating center, and study staff. In addition, we sincerely thank and recognize the families and participants of the LONGSCAN study for providing their time and valuable information.

Notes

¹The wording of the sexual intercourse item did not explicitly ask youth to exclude penetration that occurred in the context of the CSA experience. However, review of the CPS records suggest that only one of the youth whose CSA allegation included penetration endorsed sexual intercourse at age 14. In addition, we conducted a chi-square analyses within the youth who have a history of a CSA allegations and compared youth who ever had an allegation(s) that included penetration versus those whose allegation(s) never included penetration on their response to the sexual intercourse item at age 14. The chi-square was not significant.

Note: Two-way interactions of SA and gender and SA and respective maltreatment or witnessed violence experience were entered on Block 4 of Models 2 to 5; however, because none of the 2-way interactions were statistically significant they were not included in the table. Site was not covaried in analyses as already controlled in trajectory analyses. S = p < .05 (+ or – reflects direction of association). SA = sexual abuse; PA = physical abuse; EA = emotional abuse; N = neglect; WV = witnessed violence.

^a Boy = 0, girl = 1.

^b Curvilinear group relative to low group.

^c High Level Remit relative to no allegations.

^d Low Level Chronic relative to No Allegations.

^e High Level Remit relative to No Allegations.

^f Low Level Chronic relative to No Allegations.

^g High Level Remit relative to No Allegations.

^h Low Level Chronic relative to No Allegations.

ⁱ High Level Chronic relative to No Allegations.

²Although the aim of the current study was to replicate and extend prior work by examining prospective associations between CSA history and risky behavior in adolescence, the case could be made that new allegations of CSA at the age 14 interview had a more salient impact on risky behavior at the same time point. In addition to the problem of disentangling the directionality of the associations between CSA and risky behavior at age 14, only four youth in the CSA group had an additional CSA allegation at age 14, decreasing the likelihood that the obtained association is better accounted for by CSA at age 14.