Showing papers by "Susan D. Hillis published in 2001"

Adverse childhood experiences and sexual risk behaviors in women: a retrospective cohort study.

Abstract: A total of 5060 female members of a managed care organization provided information about seven categories of adverse childhood experiences: having experienced emotional physical or sexual abuse; or having had a battered mother or substance-abusing mentally ill or criminal household members. Logistic regression was used to model the association between cumulative categories of up to seven adverse childhood experiences and such sexual risk behaviors as early onset of intercourse 30 or more sexual partners and self-perception as being at risk for AIDS. Each category of adverse childhood experiences was associated with an increased risk of intercourse by age 15 (odd ratios 1.6-2.6) with perceiving oneself as being at risk of AIDS (odds ratios 1.5-2.6) and with having had 30 or more partners (odds ratios 1.6-3.8). After adjustment for the effects of age at interview and race women who experienced rising numbers of types of adverse childhood experiences were increasingly likely to see themselves as being at risk of AIDS: Those with one such experience had a slightly elevated likelihood (odds ratio 1.2) while those with 4-5 or 6-7 such experiences had substantially elevated odds (odds ratios 1.8 and 4.9 respectively). Similarly the number of types of adverse experiences was tied to the likelihood of having had 30 or more sexual partners rising from odds of 1.6 for those with one type of adverse experience and 1.9 for those with two to odds of 8.2 among those with 6-7. Finally the chances that a woman first had sex by age 15 also rose progressively with increasing numbers of such experiences from odds of 1.8 among those with one type of adverse childhood experience to 7.0 among those with 6-7. Among individuals with a history of adverse childhood experiences risky sexual behavior may represent their attempts to achieve intimate interpersonal connections. Having grown up in families unable to provide needed protection such individuals may be unprepared to protect themselves and may underestimate the risks they take in their attempts to achieve intimacy. If so coping with such problems represents a serious public health challenge. (authors)