title: The effects of early sexual abuse on adult risky sexual behaviors among persons with severe mental illness.
abstract: OBJECTIVE
  There were two aims: first, to examine the relationship between prior sexual abuse and three types of adult risky sexual behaviors [(1) ever traded sex for drugs or money, (2) had unprotected sex in the past 6 months, and (3) frequency of unprotected sex in the past 6 months] among persons with severe mental illness (SMI), and second, to examine the potential mediating effects of adult rape, substance use, and PTSD.
  
  
  METHODS
  Using a pooled sample of individuals with SMI (N=609), logistic and negative binomial regression analyses were used to investigate the impact of prior sexual abuse on these adult risky sexual behaviors.
  
  
  RESULTS
  Childhood sexual abuse was associated with having ever traded sex for money and having engaged in unprotected sex in the past 6 months. However, childhood sexual abuse was inversely associated with the number of times males had unprotected sex in the past 6 months. Results differed between males and females and the impact of potential mediators also varied by gender and type of outcome studied.
  
  
  CONCLUSIONS
  These findings suggest a complex link between childhood sexual abuse and adult risky sexual behaviors in persons with SMI. Clinical assessments of child abuse sequelae should include a variety of indicators and parameters of adult risky sexual behavior, as persons with SMI are at an increased risk of engaging in high-risk sexual behaviors and tend to have a higher exposure to childhood sexual abuse than does the general population.
authors.affiliation: Services Effectiveness Research Program, Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Box 3071, 905 W. Main Street, Ste 23A, Durham, NC 27710, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Van Dorn
authors.forename: Sarah
authors.initials: S
authors.lastname: Mustillo
authors.forename: Eric B
authors.initials: EB
authors.lastname: Elbogen
authors.forename: Shannon
authors.initials: S
authors.lastname: Dorsey
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Swanson
authors.forename: Marvin S
authors.initials: MS
authors.lastname: Swartz
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D012044:Regression Analysis; D012309:Risk-Taking; D012725:Sexual Behavior; D017741:Survivors / Q000523:psychology*; D014481:United States