Dissociation-Pathway Towards Risk Behaviors in Women

描述（由申请人提供）：儿童性虐待是一个普遍存在的问题，影响了很大比例的女性。报告有儿童性虐待史的妇女更有可能在以后继续遭受暴力和一系列危险行为，对未来的健康问题构成更大的风险。性传播疾病造成大量发病率，可造成长期后果，是一个重大的公共卫生问题。负责任的性行为是《2010年健康人》的主要健康指标，性传播疾病在“改善健康”目标中得到解决。研究表明，农村妇女获得保健的机会较少，与虐待有关的资源较少，提供者对暴力的了解也较少。据报告，经历过儿童性虐待的成年妇女有心理压力和精神分裂，这可能会阻止妇女从事与性活动有关的保护行为。由于文献中存在大量相互关联的变量，这种分离是否影响安全性行为的机制还没有得到很好的理解。提出的横断面描述性研究将探讨儿童性虐待史、分离、当前虐待、物质使用、创伤后应激障碍行为对农村妇女性行为实践结果的影响。本研究的目的是：（主要目的）-探索儿童性虐待史、当前虐待、分离、物质使用和创伤后应激行为对农村妇女安全性行为的影响；（次要目的）-确定儿童性虐待史、当前虐待、分离、物质使用和创伤后应激行为等变量之间的关系。样本为便利样本（n=207），为18岁及以上在诊所就诊的农村妇女。

DESCRIPTION (provided by applicant): Child sexual abuse is a pervasive problem that affects a large percentage of women. Women who report a history of child sexual abuse are more likely to experience a continuum of later violence and a cluster of risk behaviors, presenting an even greater risk for future health problems. Sexually transmitted diseases cause substantial morbidity, can result in long-term consequences, and are a major public health problem. Responsible sexual behavior is a leading health indicator for Healthy People 2010 and STDs are addressed in the objectives of "Improving Health". Studies have suggested that rural women have less access to health care, fewer abuse-related resources, and providers who are less informed about violence. Psychological stress and dissociation have been reported by adult women who have experienced child sexual abuse and may prevent a woman from engaging in protective behaviors related to sexual activities. Because of the number of interconnected variables in this body of literature, the mechanism by which the dissociation does or does not affect safer sex behaviors is not well understood. The proposed cross-sectional descriptive study will explore the variables of a history of child sexual abuse, dissociation, current abuse, substance use, post-traumatic stress disorder behaviors on the outcome of sexual behavior practices of rural women. The aims of this study are to: (Primary Aim)- Explore the influence of a history of child sexual abuse, current abuse, dissociation, substance use, and post-traumatic stress behaviors on safer sex practices of rural women, and (Secondary Aim)- Determine the relationship among the variables of history of child sexual abuse, current abuse, dissociation, substance use and post-traumatic stress behaviors. The sample will be a convenience sample (n=207) of rural women 18 years and older seeking healthcare at a clinic setting.