title: Types and Characteristics of Childhood Sexual Abuse: How Do They Matter in HIV Sexual Risk Behaviors Among Women in Methadone Treatment in New York City?
abstract: BACKGROUND
  Childhood sexual abuse (CSA) is often considered an important distal factor in HIV sexual risk behaviors; however, there are limited and mixed findings regarding this relationship among women experiencing substance use problems. In addition, research with this population of women has yet to examine differences in observed CSA-HIV sexual risk behaviors relationships by CSA type and characteristics.
  
  
  OBJECTIVE
  This study examines relationships between CSA coding, type, and characteristics and HIV sexual risk behaviors with main intimate partners among a random sample of 390 women in methadone treatment in New York City who completed individual interviews with trained female interviewers.
  
  
  RESULTS
  Findings from logistic regression analyses indicate that CSA predicts substance use with sexual activity, with variations by CSA coding, type, and characteristics; however, the role of CSA is more limited than expected. Having a main partner with HIV risk mediates some relationships between CSA and drinking four or more drinks prior to sex. Intimate partner violence is the most consistent predictor of sexual risk behaviors. Other salient factors include polysubstance use, depression, social support, recent incarceration, relationship characteristics, and HIV status.
  
  
  CONCLUSIONS
  This study contributes to understanding of relationships between CSA and HIV sexual risk behaviors and key correlates associated with HIV sexual risk behaviors among women in methadone treatment. It also highlights the complexity of measuring CSA and its association with sexual risk behaviors and the importance of comprehensive approaches to HIV prevention that address psychological, relational, situational, and substance use experiences associated with sexual risk behaviors among this population.
authors.affiliation: a School of Social Policy & Practice , University of Pennsylvania , Philadelphia , Pennsylvania , USA.
authors.forename: Malitta
authors.initials: M
authors.lastname: Engstrom
authors.affiliation: b Kent School of Social Work , University of Louisville , Louisville , Kentucky , USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Winham
authors.affiliation: c Social Intervention Group, Columbia University , New York , New York , USA.
authors.forename: Louisa
authors.initials: L
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Childhood sexual abuse measurement; HIV sexual risk; methadone treatment