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. 2019 Aug;65(2):267-273.
doi: 10.1016/j.jadohealth.2019.02.015. Epub 2019 Apr 28.

Gender and Race Informed Pathways From Childhood Sexual Abuse to Sexually Transmitted Infections: A Moderated Mediation Analysis Using Nationally Representative Data

Rebecca L Fix  1 , Luciana C Assini-Meytin  2 , PhuongThao D Le  2
Affiliations

Gender and Race Informed Pathways From Childhood Sexual Abuse to Sexually Transmitted Infections: A Moderated Mediation Analysis Using Nationally Representative Data

Rebecca L Fix et al. J Adolesc Health. 2019 Aug.

Abstract

Purpose: Although data suggest child sexual abuse is linked with increased risk of contracting asexually transmitted infection (STI), the mechanisms through which these experiences are connected remain understudied. Moreover, there is a need to explore how race/ethnicity and gender influence these processes.

Methods: The present study examined the mediational pathways from child sexual abuse to risky sexual behavior to STIs and further evaluated the role of depressive symptomatology and nonmedical prescription drug use on the relationship between child sexual abuse and risky sexual behavior. In addition, race and gender were examined as moderators to account for potential different effects of these mechanisms on females and males and on different racial and ethnic groups. A nationally representative sample of 4,181 youth from the Add Health dataset was used.

Results: Results from a moderated mediation model indicated risky sexual behavior partially mediated the pathway from child sexual abuse to STI contraction and depressive symptomatology and nonmedical prescription drug use partially mediated pathway from child sexual abuse to risky sexual behavior. Race and gender moderated the relationship between risky sexual behavior and STI contraction.

Conclusions: Findings underscore the need for STI prevention efforts among adolescents to focus on risk factors beyond risky sexual behaviors, such as childhood sexual abuse and mental health screening that includes depressive symptomatology and nonmedical prescription drug use. In addition, findings emphasize the need to further examine the different effects on different racial/ethnic and gender subgroups, particularly black women.

Keywords: Disparities; Female; Mental health; Sexual assault.

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Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Conceptual moderated mediation model of the pathway from child sexual abuse to subsequently contracted sexually transmitted infections.
Figure 2.
Figure 2.
Moderated mediation model of the pathway from child sexual abuse to subsequently contracted sexually transmitted infections. **p < .01; ***p < .001.
See this image and copyright information in PMC

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