Childhood sexual abuse, adolescent sexual behaviors and sexual revictimization.
OBJECTIVE
The aims of this study were to examine the extent to which exposure to childhood sexual abuse (CSA) was associated with increased rates of sexual risk taking behaviors and sexual revictimization during adolescence.


METHODS
A birth cohort of 520 New Zealand born young women was studied at regular intervals from birth to the age of 18. At age 18 retrospective reports of CSA were obtained from sample members. Over the course of the 18 year study information was gathered on: (a) childhood, family, and related circumstances; and (b) the young women's history of sexual experiences from 14 to 18 years.


RESULTS
Young women reporting CSA, and particularly severe CSA involving intercourse, had significantly higher rates of early onset consensual sexual activity, teenage pregnancy, multiple sexual partners, unprotected intercourse, sexually transmitted disease, and sexual assault after the age of 16. Logistic regression analyses suggested that the associations between CSA and sexual outcomes in adolescence arose by two routes. First, exposure to CSA was associated with a series of childhood and family factors including social disadvantage, family instability, impaired parent child relationships, and parental adjustment difficulties that were also associated with increased sexual vulnerability in adolescence. Second, there appeared to be a causal chain relationship between CSA and sexual experiences in which CSA was associated with early onset sexual activity which, in turn, led to heightened risks of other adverse outcomes in adolescence.


CONCLUSIONS
The findings of this study suggest that those exposed to CSA have greater sexual vulnerability during adolescence. This appears to arise because: (a) the childhood and family factors that are associated with CSA are also associated with increased sexual risks during adolescence; and (b) exposure to CSA may encourage early onset sexual activity which places those exposed to CSA at greater sexual risk over the period of adolescence.
Fergusson
D M
DM
Department of Psychological Medicine, Christchurch Health & Development Study, Christchurch School of Medicine, New Zealand.
Horwood
L J
LJ
Lynskey
M T
MT
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D017668:Age of Onset; D016009:Chi-Square Distribution; D002648:Child; D002650:Child Abuse, Sexual / Q000145:classification / Q000523:psychology / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003268:Contraception Behavior; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D009520:New Zealand / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data; D011446:Prospective Studies; D011902:Rape / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology