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Sexual Abuse in Childhood Raises Risk of HIV and Other Sexual Infections

August 2012

A large study of adult women and men in the United States found that 15% of women and 5% of men had been sexually abused as children.1 Among both women and men, sexual abuse was more common among bisexuals, lesbians and gays, and heterosexuals who had same-sex partners than among heterosexuals without same-sex partners. Adults who had been sexually abused as children had higher rates of infection with HIV or other sexually transmitted infections (STIs).

Several previous studies found higher rates of childhood sexual abuse among lesbians, gays, and bisexuals than among heterosexual women and men. But many of these studies were too small to analyze differences between bisexuals and lesbians or gays, and most previous studies focused only on women or only on men. These studies had another disadvantage when trying to figure out the impact of childhood sexual abuse: they lacked a comparison group of heterosexuals.

Being sexually abused as a child is not rare in the United States. People who are sexually abused as children often grow to adolescence and adulthood facing several problems (including alcohol and drug use), and adopting sexual behavior that puts them at risk of STIs including HIV infection.

Yet many people -- especially men -- are reluctant to talk about being sexually abused as a child or even to admit that it happened. As a result, it can be difficult to determine how many adults were abused as children and what impact this experience had on their behavior and infection risk as they grew up.

To learn more about the impact of childhood sexual abuse in lesbians, gays, bisexuals, and heterosexuals, researchers took advantage of a large U.S. survey involving more than 34,000 people across the United States. Because of this survey's large size, the researchers were able to make comparisons and analyze data in ways that were not possible in smaller studies.


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How the Study Worked

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is a large, ongoing study that has had two waves, the first in 2001-2002 and the second in 2004-2005. NESARC participants complete a face-to-face computer-assisted interview in their homes.

This childhood-abuse study included people who participated in wave 2. Researchers focused on men and women who answered questions about childhood sexual abuse and their current sexual orientation, attractions, and behaviors.

The researchers defined childhood sexual abuse as a sexual experience with any other person when the individual did not want to have the sexual experience or was too young to know what was happening. The sexual experience could include (1) being touched or fondled in a sexual way, (2) being forced to touch another in a sexual way, (3) sexual intercourse, or (4) attempted sexual intercourse.

The research team rated the frequency of childhood sexual abuse as (1) never, (2) almost never, or (3) sometimes/frequent. They divided people who completed the survey into five sexual-orientation groups: (1) gay or lesbian, (2) bisexual, (3) heterosexual with at least some same-sex partners, (4) heterosexual with some same-sex attraction but no same-sex partners, or (5) heterosexual with no same-sex partners or attraction.

The researchers used standard statistical methods to calculate (1) the association between sexual orientation and childhood sexual abuse and (2) the impact of childhood sexual abuse on risk of HIV and other STIs.


What the Study Found

Of the nearly 20,000 women who completed the survey, 142 (0.6%) called themselves lesbians, 159 (0.8%) bisexual, 311 (1.5%) heterosexual with some same-sex partners, 946 (4.6%) heterosexual with some same-sex attraction, and 18,407 (92.5%) heterosexual with no same-sex partners or attraction.

Among all the women studied, 14.9% reported some childhood sexual abuse, including 7.2% who reported abuse sometimes or frequently and 7.7% who reported abuse almost never. Childhood sexual abuse was more frequent among bisexual women (43.5%), lesbians (38.1%), and heterosexuals with same-sex partners (28%) than among heterosexual women with no samesex partners (14.2%).

Compared with heterosexual women with no samesex partners or attractions, bisexual women were more than 5 times as likely to report childhood sexual abuse, while lesbians and heterosexual women with same-sex partners were about 3 times as likely to report childhood sexual abuse (Figure 1).


Chances of Childhood Sexual Abuse by Adult Sex Preference in U.S. Women

Figure 1. Among women surveyed in a large U.S. study, bisexuals, lesbians, and heterosexuals with same-sex partners or attractions were more likely to be sexually abused as children than heterosexuals (HTX) without same-sex partners or attractions.


Of the 14,297 men surveyed, 188 (1.1%) identified themselves as gay, 80 (0.4%) as bisexual, 363 (2.4%) as heterosexual with some same-sex partners, 293 (1.8%) as heterosexual with some same-sex attraction, and 13,373 (94.3%) as heterosexual with no same-sex partners or attraction.

Among all men, 5.2% reported some childhood sexual abuse, including 1.8% abused sometimes or frequently and 3.5% abused almost never. Any childhood sexual abuse was reported by similar proportions of bisexual men (19%), gay men (18.6%), and heterosexual men with same-sex partners (19.4%), while 4.6% of heterosexual men without same-sex partners or attractions reported any childhood sexual abuse.

Compared with heterosexual men without same-sex partners or attractions, bisexuals were almost 13 times as likely to report childhood sexual abuse, while gays were 9.5 times as likely, and heterosexuals with samesex partners were 7.9 times as likely (Figure 2).


Chances of Childhood Sexual Abuse by Adult Sex Preference in U.S. Men

Figure 2. Among men surveyed in a large U.S. study, bisexuals, gays, and heterosexuals with same-sex partners were more likely to be sexually abused as children than heterosexuals (HTX) without same-sex partners or attractions.


Women and men who experienced childhood sexual abuse were more likely to have HIV infection or another sexually transmitted infection as an adult:

Compared with women not sexually abused as a child, (1) heterosexual women almost never abused were 1.6 times as likely to become infected with HIV or another STI and (2) heterosexual women sometimes or frequently abused were 2.8 times as likely to get HIV or another STI. Compared with women not sexually abused as a child, (1) lesbians, bisexuals, and heterosexuals with same-sex partners who were almost never sexually abused were 7 times as likely to get HIV or an STI and (2) lesbians, bisexuals, and heterosexuals with same-sex partners who were sometimes or frequently abused were 3.8 times as likely to get HIV or an STI.

Compared with men not sexually abused as a child, (1) heterosexual men sometimes or frequently abused were 1.5 times as likely to get infected with HIV or another STI, and (2) gay, bisexual, or heterosexual men with same-sex partners who were sometimes or frequently abused were 4.2 times as likely to become infected with HIV or another STI.

What the Results Mean for You

Adults who are bisexual, lesbian or gay, or heterosexual with some same-sex partners, were more likely to be sexually abused as children than heterosexuals with no same-sex partners. But this does not mean childhood sexual abuse caused these people to become bisexual, lesbian, or gay.
Because of the large size of this study of childhood sexual abuse, the results probably apply to everyone in the United States. One big advantage of this study is that is compares (1) bisexuals, lesbians, gays, and heterosexuals with samesex partners or attractions with (2) heterosexuals who don't have same-sex partners or feel same-sex attractions. The groups with same-sex partners had much higher rates of childhood sexual abuse than heterosexuals without same-same partners.

This overall finding does not mean that childhood sexual abuse causes people to become lesbian, gay, or bisexual. A more likely explanation for this link is that children who showed lesbian, gay, or bisexual behaviors early in life are more vulnerable and more likely to become targets of sexual abuse. In previous studies, lesbian, gay, and bisexual adults remember feeling sexually different as children and -- as a result -- being sexually or physically abused by adults or other youngsters.

Children and teenagers who feel attracted to youngsters of the same sex do not have to put up with this kind of abuse -- from other youngsters or from any family members or other adults. Youngsters who are sexually or physically abused should tell an adult they trust right away, starting with a parent or a school counselor or teacher you trust.

Lesbian and gay support groups for youngsters are available in many areas. If you need a support group and can't find one on your own, talk to a school counselor, a teacher you trust, your healthcare provider, or another adult you trust. To find these groups online, see the box "Finding Gay and Lesbian Support Groups for Youngsters and Adults."


Finding Gay and Lesbian Support Groups for Youngsters and Adults
  • The Gay, Lesbian and Straight Education Network (GLSEN) strives to assure that each member of every school community is valued and respected regardless of sexual orientation or gender identity/expression.
  • Parents, Families and Friends of Lesbians and Gays (PFLAG) promotes the health and well-being of lesbian, gay, bisexual, and transgender persons, their families and friends.
  • Human Rights Campaign (HRC) is the largest civil rights organization in the United States working to achieve lesbian, gay, bisexual, and transgender equality.
  • The It Gets Better Project features online videos and an MTV special showing young people talking about growing up gay.
  • The Gay & Lesbian Alliance Against Defamation (GLAAD) empowers people to share their stories, holds the media accountable for the words and images they present, and helps grassroots organizations communicate effectively.
  • MTV's A Thin Line Campaign empowers young people nationwide to draw their own line between digital use and digital abuse -- including cyberbullying, sexting, and all types of digital harassment.
  • The Trevor Project focuses on crisis and suicide prevention efforts among lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. If you or someone you know needs help, call the Trevor Lifeline at 866-4-U-TREVOR (866-488-7386) to speak with a trained counselor. It's toll-free and available 24/7.


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This study found that adults who were sexually abused as children were much more likely to become infected with HIV or another sexually transmitted infection (STI). The reasons for this link are complicated. Sexual abuse during childhood often has a lifelong impact. Because abused children sometimes feel that they caused the abuse, they may feel sad and guilty, and they may be more likely to do other risky things (like drink alcohol, use drugs, or have sex without a condom).

It's difficult even for adults to talk about childhood sexual abuse. But talking about such abuse with a healthcare professional can help you understand what happened. And that understanding can be a first step to overcoming behavior problems that may have begun with childhood sexual abuse. Your primary healthcare provider can recommend a counselor or therapist who will make it easier for you to talk about childhood sexual abuse and the impact it has on your life.

Many studies, including this one, find that men report childhood sexual abuse less often than women. Girls may be victims of sexual abuse more than boys. But it also seems clear that men are more uncomfortable talking about childhood sexual abuse than women. As this study shows, men who were sexually abused as boys continue to suffer consequences of that abuse as adults. Men should not feel ashamed of being abused during childhood. They should make an effort to talk about it with a healthcare professional.


Reference

  1. Sweet T, Welles SL. Associations of sexual identity or same-sex behaviors with history of childhood sexual abuse and HIV/STI risk in the United States. J Acquir Immune Defic Syndr. 2012;59:400-408.




This article was provided by The Center for AIDS. It is a part of the publication HIV Treatment ALERTS!. You can find this article online by typing this address into your Web browser:
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