title: Childhood sexual abuse and adult sexual health among indigenous Kanak women and non-Kanak women of New Caledonia.
abstract: OBJECTIVE
  Few studies have addressed the long-term consequences of adverse childhood experiences among women in Oceania, in particular among indigenous women. This paper aims to report prevalences of childhood sexual abuse (CSA) and to asses the negative sexual health consequences in adulthood by comparing indigenous Kanak to non-Kanak women in New Caledonia.
  
  
  METHODS
  Data come from a population survey on violence against women and health. Face-to-face interviews were conducted in 2002-2003 with adult women randomly selected from the electoral list. Separate models for Kanak (n=329) and non-Kanak women (n=426) were performed. Regression models adjusted for relevant socio-demographics factors were conducted to estimate the odds ratios for the associations between childhood sexual abuse and adult sexual health outcomes.
  
  
  RESULTS
  A non-significant difference between Kanak (11.8%) and non-Kanak women (14.4%) was found for the prevalence of CSA. Among Kanak women, CSA increases the risk of sexually transmitted infections, of non-desired sexual intercourse with an intimate partner and of experience of adult sexual violence. However, use of modern contraception as an adult was more frequent among CSA Kanak victims, as compared to other Kanak women. Among non-Kanak women, only abortion appeared significantly associated with CSA.
  
  
  CONCLUSIONS
  The findings show that in all ethnic communities of New Caledonia, a history of child sexual abuse is not rare among women. They also shed light on the long-term consequences of CSA, suggesting that the effect of CSA may differ according to ethnic membership and subsequent social stratification and gender norms. Efforts to break the silence around violence against girls and establish a stronger foundation are required in New Caledonia. Prevention programs on violence against women and sexual health that take into account the cultural and social heterogeneity are needed.
authors.affiliation: INSERM, UMRS 1018, CESP, Epidemiology of Occupational and Social Determinants of Health, Hôpital Paul Brousse, 16 Av. Paul Vaillant-Couturier, Villejuif Cedex, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Hamelin
authors.forename: Christine
authors.initials: C
authors.lastname: Salomon
authors.forename: Diane
authors.initials: D
authors.lastname: Cyr
authors.forename: Alice
authors.initials: A
authors.lastname: Gueguen
authors.forename: France
authors.initials: F
authors.lastname: Lert
mesh_terms: D000293:Adolescent; D000328:Adult; D002650:Child Abuse, Sexual / Q000208:ethnology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009510:New Caledonia / Q000453:epidemiology; D044382:Population Groups; D055815:Young Adult