Associations between History of Child Maltreatment and High Risk Sexual Behaviors in Emerging Adulthood: The Role of Healthcare Access Open Access
Pattee, Jamie (Spring 2022)
Published
Abstract
Introduction: This study examined whether healthcare access modifies the association between child maltreatment and risky sexual behaviors in emerging adults.
Methods: Data from 12,706 young adults from the Add Health Study, a nationally representative cohort, were examined. The outcome measured was presence of one of the following risky sexual behaviors reported at Wave III: multiple sexual partners, transactional sex, known partner with an STD, no condom use, and the regret of being in a sexual situation due to drugs or alcohol. Exposures measured were child physical abuse, sexual abuse, and neglect. The effect modifier was complete healthcare access, defined as recently consulting a provider, having insurance coverage, and not having an instance of failure to get medical care when needed. Predictive margins were utilized to estimate prevalence ratios (PRs) for associations between childhood maltreatment and engagement in a high-risk sexual behavior stratified by biological sex and healthcare access.
Results: Females experienced less child maltreatment than males (19.9% vs. 26.3%). Males were slightly more likely than females to have complete healthcare access (10.2% vs. 9.3%). For females with limited healthcare access relative to females with complete access, the prevalence of high-risk sexual behavior was marginally higher among those with a history of physical abuse (PRs 1.12 vs. 1.08) and sexual abuse (PRs 1.22 vs. 0.99), but not neglect (PRs 1.16 vs. 1.17) when compared to females without a history of these respective maltreatments. For males with limited healthcare access relative to males with complete access, the prevalence of high-risk sexual behaviors was higher among those with a history of neglect (PRs 1.20 vs. 0.97), but not physical abuse (PRs 1.06 vs. 1.06) or sexual abuse (PRs 1.25 vs. 1.26) when compared to males without a history of these respective maltreatments. The difference magnitudes were small between groups with and without complete access and the 95% confidence intervals overlapped.
Discussion: Our findings indicate that there is likely no meaningful modification of the association between child maltreatment and high-risk sexual behavior by healthcare access. There is a need for improvement in sexual health services for young adults with a history of child maltreatment.
Table of Contents
Chapter I: Background and Literature Review
Add Health Study 1
Sexual Health and Risky Sexual Behaviors in Young Adults 2
Childhood Maltreatment 5
Healthcare Access among Young Adults 6
Chapter II: Manuscript
Introduction 9
Methods 10
Results 13
Discussion 16
References 19
Tables 23
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