title: Pathways from childhood abuse and neglect to HIV-risk sexual behavior in middle adulthood.
abstract: OBJECTIVE
  This study examines the relationship between childhood abuse and neglect and sexual risk behavior in middle adulthood and whether psychosocial factors (risky romantic relationships, affective symptoms, drug and alcohol use, and delinquent and criminal behavior) mediate this relationship.
  
  
  METHODS
  Children with documented cases of physical abuse, sexual abuse, and neglect (ages 0-11) processed during 1967-1971 were matched with nonmaltreated children and followed into middle adulthood (approximate age 41). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Past year HIV-risk sexual behavior was assessed via self-reports during 2003-2004 (N = 800). Logistic regression was used to examine differences in sexual risk behavior between the abuse and neglect and control groups, and latent variable structural equation modeling was used to test mediator models.
  
  
  RESULTS
  Child abuse and neglect was associated with increased likelihood of risky sexual behavior in middle adulthood, odds ratio = 2.84, 95% CI [1.74, 4.64], p ≤ .001, and this relationship was mediated by risky romantic relationships in young adulthood.
  
  
  CONCLUSIONS
  Results of this study draw attention to the potential long-term consequences of child abuse and neglect for physical health, in particular sexual risk, and point to romantic relationships as an important focus of intervention and prevention efforts.
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA. helen.wilson@rosalindfranklin.edu
authors.forename: Helen W
authors.initials: HW
authors.lastname: Wilson
authors.forename: Cathy Spatz
authors.initials: CS
authors.lastname: Widom
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology*; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology