Adult Sexual Risk Behavior Among Women With a History of Childhood Sexual Abuse

• Frequency of unprotected intercourse [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]
• Proportion of episodes of unprotected intercourse [ Time Frame: Measured at Month 3 ] [ Designated as safety issue: No ]

This study will evaluate whether childhood experiences are related to current sexual behavior of adult women.

Adverse childhood events, including physical and sexual abuse, can cause significant distress for those affected, during both childhood and adulthood. Childhood abuse appears to increase the risk of a number of negative outcomes later in life, including psychiatric disorders, substance abuse, and HIV and sexually transmitted infections. Previous research has consistently found an association between childhood sexual abuse and greater rates of adult sexual risk behavior. However, improved understanding of how childhood sexual abuse relates to adult sexual risk behavior is needed. The Information-Motivation-Behavioral Skills and Traumagenic Dynamics models are theories used to investigate determinants of sexual behavior and effects of childhood abuse. Using these models to examine the relationship between childhood sexual abuse and adult sexual risk behavior may help in creating effective sexual risk reduction interventions for women abused during childhood. This study will evaluate whether childhood experiences are related to current sexual behavior of adult women. The study will also evaluate which theory, the Information-Motivation-Behavioral Skills model or the Traumagenic Dynamics model, better mediates the relationship between childhood sexual abuse and adult sexual risk behavior.

Participation in this study will include one study visit. Participants will first complete a 45-minute computerized survey that includes questions about childhood experiences; family environment; current health and behavior; attitudes, knowledge, and thoughts about sex and relationships; control over life circumstances; and substance use. Participants will then engage in two brief role plays in which they will either make a request of their partner or must stand up for themselves. For the last part of the visit, participants will be asked questions about condoms and condom use and will be asked to place a condom on a model used in the clinic.

This study will include women seeking treatment at the Monroe County Health Department STD Clinic.

• HIV Infections
• Child Abuse, Sexual

• Behavioral: Information-Motivation-Behavioral Skills model
  The Information-Motivation-Behavioral Skills model is an influential and empirically supported theory of health behavior. The model suggests that HIV-related information, motivation, and behavioral skills are important determinants of sexual behavior; thus, childhood sexual abuse may lead to deficits in these areas. This model will be used to guide research interviews.
• Behavioral: Traumagenic Dynamics model
  The Traumagenic Dynamics model is an influential and empirically supported model of the effects of childhood sexual abuse. The model suggests that childhood sexual abuse leads to traumatic sexualization, stigmatization, betrayal, and powerlessness and that these four traumagenic dynamics lead to adverse outcomes, including increased rates of sexual risk behavior. This model will be used to guide research interviews.

• 1
  Women who report a history of childhood sexual abuse
  Interventions:

  • Behavioral: Information-Motivation-Behavioral Skills model
  • Behavioral: Traumagenic Dynamics model
• 2
  Women who do not report a history of childhood sexual abuse
  Interventions:

  • Behavioral: Information-Motivation-Behavioral Skills model
  • Behavioral: Traumagenic Dynamics model

Inclusion Criteria:

• Understands English

Exclusion Criteria:

• Impaired mentally