Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking
Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking
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DOI：
10.1016/s0749-3797(99)00084-7
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发表时间：
2000-02-01
影响因子：
5.5
通讯作者：
Simmons, KW
中科院分区：
文献类型：
--
作者：
Bensley, LS;Van Eenwyk, J;Simmons, KW
背景：尽管对临床样本的研究已经确定了儿童期虐待，特别是性虐待与成人健康危险行为之间的联系，但这些发现对人群的普适性以及不同类型虐待在男性和女性中的相对重要性尚不清楚。目的：在控制了年龄和教育因素后，估计在一般人群样本中，男性和女性自我报告的成人艾滋病毒危险行为和大量饮酒与自我报告的儿童期身体和/或性虐待史相关的风险。第二个目标是确定在女性中，早期和慢性性虐待是否与较晚或较小范围的性虐待相比风险较高。设计：1997年华盛顿州行为风险因素监测系统(BRFSS)以人群为基础的电话调查询问了具有代表性的成年人样本，她们在童年时是否曾遭受过身体或性虐待，如果有，第一次发生时的死亡年龄和发生次数。调查还询问了酒精使用水平以及50岁以下人群的艾滋病毒风险行为。参与者：华盛顿州3,473名说英语的非制度化平民成年人。主要观察指标：过去自我报告的艾滋病毒风险行为和过去一个月的大量饮酒。结果：我们确定了报告的滥用史与我们检查的每一种健康风险行为之间的关联。对于女性来说，早期和慢性性虐待(没有发生非性身体虐待)与艾滋病毒危险行为增加7倍以上相关(优势比[OR]，7.4；95%可信区间[CI]2.4至23.5)；任何性虐待，加上身体虐待，与这些危险行为的三倍增加有关(OR，5.0；95%CI，2.2至11.5)。对于女性，只有性虐待和身体虐待与酗酒有关(OR，6.2；95%CI，2.2-16.9)。身体虐待本身与女性的这两种健康风险行为都没有关联。对于男性，任何性虐待都与艾滋病毒危险行为增加8倍相关(OR，7.9；95%CI，1.8至35.1)。仅身体虐待与艾滋病毒危险行为的风险增加3倍(OR，3.2；95%CI，1.3至7.9)和酗酒风险的类似增加(OR，3.2；95%CI，1.8至5.5)有关。虽然只有29%的女性和19%的男性被问及艾滋病毒危险行为时报告了任何儿童期虐待史，但在报告艾滋病毒危险行为的人中，这些人分别占51%和50%。对于重度饮酒，相应的数字是25%的女性和23%的男性报告了任何虐待行为，分别占报告重度饮酒的45%和33%。结论：预防或补救成人健康危险行为的努力应该考虑儿童虐待的可能性，因为在一般人口调查中，报告艾滋病毒危险行为或大量饮酒的人中有三分之一到一半也报告了童年虐待。(C)2000年《美国预防医学杂志》。
Context: Although studies of clinical samples have identified links between childhood abuse, especially sexual abuse, and adult health-risk behaviors, the generalizability of these findings to the population and the relative importance of different types of abuse in men and women are not known.Objective: To estimate the risk of self-reported adult HIV-risk behaviors and heavy drinking that is associated with self-reported childhood histories of physical and/or sexual abuse for men and women in a general-population sample, after controlling for age and education. A second objective is to determine whether, among women, early and chronic sexual abuse is associated with heightened risk compared to later or less extensive abuse.Design: A population-based telephone survey, the 1997 Washington State Behavioral Risk Factor Surveillance System (BRFSS), asked a representative sample of adults whether they had ever been physically or sexually abused in childhood, and if so, die age at first occurrence and number of occurrences. The survey also asked about levels of alcohol use and, for those under 50 years, about HIV-risk behaviors.Participants: Three thousand four hundred seventy-three English-speaking non-institutionalized civilian adults in Washington State.Main Outcome Measures: Self-reported HIV-risk behaviors in the past rear and heavy drinking in the past month.Results: We identified associations between reported abuse history and each health-risk behavior that we examined. For women, early and chronic sexual abuse (occurring without nonsexual physical abuse) was associated with more than a 7-fold increase in HIV-risk behaviors (odds ratio [OR], 7.4; 95% confidence intervals [CI] 2.4 to 23.5); and any sexual abuse, combined with physical abuse, was associated with a ti-fold increase in these risk behaviors (OR, 5.0; 95% CI, 2.2 to 11.5). For women, only combined sexual and physical abuse was associated with heavy drinking (OR, 6.2; 95% CI, 2.2 to 16.9). Physical abuse alone was not associated with either health-risk behavior for women. For men, any sexual abuse was associated with an 8-fold increase in HIV-risk behaviors (OR, 7.9; 95% CI, 1.8 to 35.1). Physical abuse alone was associated with a 3-fold increase in risk of HIV-risk behaviors (OR, 3.2; 95% CI, 1.3 to 7.9) and a similar increase in risk of heavy drinking (OR, 3.2; 95% CI, 1.8 to 5.5). Although only 29% of the women and 19% of the men who were asked about HIV-risk behaviors reported any history of childhood abuse, these accounted for 51% and 50% of those reporting HIV-risk behaviors, respectively. For heavy drinking the corresponding figures were 25% of the women and 23% of the men reporting any abuse, who accounted for 45% and 33% of those reporting heavy drinking, respectively.Conclusions: Efforts to prevent or remediate adult health-risk behaviors should consider the possibility of a history of childhood abuse, as one third to one half of those reporting HIV-risk behaviors or heavy drinking in a general-population survey also reported childhood abuse. (C) 2000 American Journal of Preventive Medicine.