Associations of sexual identity or same-sex behaviors with history of childhood sexual abuse and HIV/STI risk in the United States

Abstract

Objective: To measure associations of childhood sexual abuse (CSA) with sexual orientation, behaviors, and attractions and HIV/sexually transmitted infection (STI) incidence in a nationally representative sample of men and women.

Methods: Data from the 2004-2005 Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed, including frequencies of CSA and HIV/STI incidence for 5 subgroups defined by sexual orientation based on identity and behaviors and attraction to the same sex or opposite sex.

Results: Overall, 14.9% of women and 5.2% of men reported CSA. Among women, bisexuals, lesbians, and heterosexuals with same-sex partners had 5.3 times, 3.4 times, and 2.9 times the odds, respectively, for CSA occurring sometimes/more frequently (vs. never) compared with heterosexuals not having same-sex partners or attractions. Among men, bisexuals, gay men, and heterosexuals with same-sex partners had 12.8 times, 9.5 times, and 7.9 times the odds, respectively, for CSA. Men and women sometimes or frequently abused had significant increases in odds for HIV/STI incidence compared with those not abused. Among women, sexual minorities had 3.8 times the odds and heterosexuals had 2.8 times the odds, whereas among men, sexual minorities had 4.2 times odds and heterosexuals had 1.5 times odds.

Conclusions: Extraordinarily high rates of CSA were observed for sexual minorities, and sexual minorities were more likely to have incident HIV or STIs, in this U.S. population survey. Identifying the impact of CSA among heterosexuals and sexual minorities in the US is a crucial first step in examining the sequelae of CSA, including the potential mediators of mental health and substance abuse disorders in the relationship between CSA and sexual risk taking.