Relationships between Rape and Reproductive Health Outcomes among Adolescent and Young Adult Women in Atlanta, Georgia Public

Abstract

Introduction. Unintended pregnancy has been associated with numerous negative health and social outcomes for both mother and their children. Adolescent and young adult women not only make up the largest proportions of unintended pregnancies, but they also are more likely to be vulnerable to the experience of sexual abuse and rape.

Objective. To examine the relationships between rape and three reproductive health experiences including sexual activity, contraceptive nonuse, and prior unintended pregnancy among young women. It is hypothesized that the experience of rape will be associated with an increased likelihood of prior unintended pregnancy, an increased likelihood of contraceptive nonuse, and an increased likelihood of current sexual activity.

Methods. Data for this secondary analysis were drawn from a community-based longitudinal study. The study comprised of a diverse sample of young women ages 15-24 years old residing in metropolitan Atlanta, Georgia. Of the 199 participants in the larger study, 148 young women who indicated that they have ever had sexual intercourse were analyzed through bivariate analyses and multivariable logistic regression models.

Results. Adolescent and young women in this sample were not shown to have statistically significant associations between rape and sexual activity, contraceptive nonuse, or prior unintended pregnancy after controlling for age, race, and current relationship status. 

Conclusions. Despite the null findings in this analysis, previous research suggests that sexual abuse is linked to the sexual reproductive health of young women. Adolescents and young adult women who have experienced sexual abuse may be at greater risk of also experiencing negative sexual and reproductive health outcomes such as unintended pregnancy. Thus, future research is needed to further investigate the multi-faceted relationship between social and environmental factors such as rape and sexual and reproductive health outcomes and experiences among young women. In addition, targeted program development, tailored interventions, policies, and clinical responses should be explored and developed.

Table of Contents

LIST OF TABLES........................................................................................................................... 5

INTRODUCTION............................................................................................................................ 1

Background...................................................................................................................... 1

Unintended Pregnancy as a public health problem....................................................... 1

Proximate behavioral determinants of unintended pregnancy........................................ 1

Gaps in research on sexual violence experiences of young women experiencing unintended pregnancy     3

Sexual violence as a public health problem................................................................... 3

Linkages between sexual abuse and women’s sexual and reproductive health................ 4

Justification...................................................................................................................... 5

Theoretical Framework..................................................................................................... 6

Purpose............................................................................................................................. 8

LITERATURE REVIEW.................................................................................................................. 9

Unintended pregnancy among young women................................................................... 9

Proximate Determinants of Unintended pregnancy......................................................... 11

Determinant 1: Sexual activity among young women................................................... 11

Determinant 2: Contraceptive behaviors among young women.................................... 12

Gaps in addressing social context and adverse life experiences....................................... 14

Sexual abuse................................................................................................................... 15

Sexual abuse among young women............................................................................. 15

The relationship between sexual abuse and sexual activity........................................... 17

The relationship between sexual abuse and contraceptive use...................................... 19

The relationship between sexual abuse and unintended pregnancy.............................. 20

METHODS..................................................................................................................................... 23

Parent Study................................................................................................................... 23

Study Description and Design..................................................................................... 23

Target population....................................................................................................... 23

Measures......................................................................................................................... 25

Primary predictor variable and outcome variables...................................................... 25

Sociodemographic variables....................................................................................... 27

Covariates................................................................................................................... 28

Analytic Sample.......................................................................................................... 28

Data analysis.............................................................................................................. 29

RESULTS....................................................................................................................................... 31

Descriptive Statistics........................................................................................................ 31

Characteristics of Sample............................................................................................ 31

Predicator Variable Characteristics............................................................................. 32

Reproductive Health Experiences................................................................................ 32

Bivariate Analyses........................................................................................................... 34

Multivariable logistic regression models.......................................................................... 37

DISCUSSION................................................................................................................................. 40

Findings.......................................................................................................................... 40

Strengths and Limitations............................................................................................ 43

Public Health Implications and Future Directions....................................................... 44

Conclusions................................................................................................................. 47

REFERENCES           49    

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	sexual assault health rape adolescents reproductive sexual young adults
Committee Chair / Thesis Advisor	Hall, Kelli Stidham, Emory University
Committee Members	Sales, Jessica, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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