title: Adverse childhood experiences, gender, and HIV risk behaviors: Results from a population-based sample.
abstract: Recent HIV research suggested assessing adverse childhood experiences (ACEs) as contributing factors of HIV risk behaviors. However, studies often focused on a single type of adverse experience and very few utilized population-based data. This population study examined the associations between ACE (individual and cumulative ACE score) and HIV risk behaviors. We analyzed the 2012 Behavioral Risk Factor Surveillance Survey (BRFSS) from 5 states. The sample consisted of 39,434 adults. Eight types of ACEs that included different types of child abuse and household dysfunctions before the age of 18 were measured. A cumulative score of ACEs was also computed. Logistic regression estimated of the association between ACEs and HIV risk behaviors using odds ratio (OR) with 95% confidence intervals (CIs) for males and females separately. We found that ACEs were positively associated with HIV risk behaviors overall, but the associations differed between males and females in a few instances. While the cumulative ACE score was associated with HIV risk behaviors in a stepwise manner, the pattern varied by gender. For males, the odds of HIV risk increased at a significant level as long as they experienced one ACE, whereas for females, the odds did not increase until they experienced three or more ACEs. Future research should further investigate the gender-specific associations between ACEs and HIV risk behaviors. As childhood adversities are prevalent among general population, and such experiences are associated with increased risk behaviors for HIV transmission, service providers can benefit from the principles of trauma-informed practice.
authors.affiliation: University of Toronto, Factor-Inwentash Faculty of Social Work, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
authors.forename: Lin
authors.initials: L
authors.lastname: Fang
authors.affiliation: University of Toronto, Factor-Inwentash Faculty of Social Work, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
authors.forename: Deng-Min
authors.initials: DM
authors.lastname: Chuang
authors.affiliation: University of Alabama at Birmingham, Humanities Building 302, Birmingham, AL 35294, USA.
authors.forename: Yookyong
authors.initials: Y
authors.lastname: Lee
keywords: ACE, adverse childhood experience; Adverse childhood experience; BRFSS, Behavioral Risk Factor Surveillance Survey; CI, confidence intervals; Childhood trauma; Gender-specific; HIV risk behaviors; OR, Odds ratio; Sexual health