title: Do Asian-American women who were maltreated as children have a higher likelihood for HIV risk behaviors and adverse mental health outcomes?
abstract: OBJECTIVE
  This study is the first to systematically investigate whether multiple child maltreatment is associated with HIV risk behaviors and adverse mental health outcomes among Asian-American women.
  
  
  METHODS
  We conducted a cross-sectional study of unmarried Chinese, Korean, and Vietnamese women (n = 400), aged 18 to 35, who are identified as children of immigrants, using computer-assisted survey interviews.
  
  
  RESULTS
  Approximately 7 in 10 women reported having been maltreated as a child and 6.8% reported any type of sexual abuse. Only 15% of our sample reported having sex at age 16 or before, yet almost 60% had ever engaged with potentially risky sexual partners. Contrary to the findings from previous studies of White and Black women, sexual abuse plus other maltreatment was not associated with HIV risk behaviors among Asian-American women. However, it was associated with a marked increase in depression, lifetime suicidal ideation, and suicide attempts. A higher education level was associated with increased odds of HIV risk behaviors, including ever having had anal sex and ever having potentially risky sexual partners.
  
  
  CONCLUSIONS
  There was no evidence indicating that multiple child maltreatment was linked with HIV risk behaviors, but it exhibited a robust association with poor mental health outcomes. These empirical patterns of internalizing trauma, suffering alone, and staying silent are in accord with Asian-cultural norms of saving face and maintaining family harmony. The prevention of multiple child maltreatment may reduce high levels of depression and suicidal behaviors in this population. It is urgent to identify victims of multiple child maltreatment and provide culturally appropriate interventions.
authors.affiliation: Boston University School of Social Work, Boston, MA 02215, USA. hahm@bu.edu
authors.forename: Hyeouk Chris
authors.initials: HC
authors.lastname: Hahm
authors.forename: Eric
authors.initials: E
authors.lastname: Kolaczyk
authors.forename: Yookyong
authors.initials: Y
authors.lastname: Lee
authors.forename: Jisun
authors.initials: J
authors.lastname: Jang
authors.forename: Lisa
authors.initials: L
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D000328:Adult; D001213:Asian / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000208:ethnology*; D002650:Child Abuse, Sexual / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D008404:Massachusetts; D008603:Mental Health / Q000208:ethnology*; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology*; D012747:Sexual Partners; D055815:Young Adult