Sexual Risk-Taking among High-Risk Urban Women with and without Histories of Childhood Sexual Abuse: Mediating Effects of Contextual Factors

Abstract

This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by being intoxicated during sex and engaging in sex work, whereas the association between relational control and unprotected sex was not mediated by contextual factors for the childhood sexual abuse group. The mechanisms of risk are different for those with divergent childhood sexual abuse histories and thus interventions should be developed to educate women with a history of childhood sexual abuse about ways to avoid revictimization, particularly within a context of poverty, prostitution, and drug use.

KEYWORDS:

• childhood sexual abuse
• drug use
• sexual risk
• HIV risk
• STI risk

This research was funded by the National Institute on Mental Health (R01 MH63631 and R01 MH069088, MR Weeks, Principal Investigator). Manuscript preparation was supported, in part, by center grant P30-MH52776 from the National Institute of Mental Health.