November 2001

Troubled Childhood May Lead to Risky Sex Behavior

By Melissa Schorr

NEW YORK (Reuters Health) - Women who were physically, verbally or sexually abused as children are more likely to engage in dangerous sexual behaviors as adults, putting them at greater risk for acquiring sexually transmitted diseases (STDs) and unintended pregnancies, public health officials warn.

"The more adversity that someone experiences as a child, the more likely they are to engage in these at-risk behaviors,'' Dr. Susan D. Hillis, a reproductive epidemiologist with the Centers for Disease Control and Prevention in Atlanta, Georgia, told Reuters Health.

Hillis and colleagues retrieved data from a 1995 survey of more than 5,000 women over the age of 25 who were members of a managed care organization.

The women were asked to report on whether their childhood experiences included physical, verbal or sexual abuse, witnessing partner violence, or living with substance abusers, criminals or mentally ill individuals.

The survey participants were also asked whether they had sex before the age of 15, had more than 30 sex partners, or considered themselves at risk for getting AIDS, a marker for engaging in sex without protection or with high-risk partners.

According to the report, published in the September/October issue of Family Planning Perspectives, nearly 60% of the women reported having had at least one of these negative experiences during childhood. Those who experienced any of these adverse childhood experiences were at an significantly increased of engaging in detrimental sexual behaviors.

For example, women who had experienced one of these adverse events were twice as likely to have had sex before the age 15 and to have had 30 or more sexual partners, compared to women who had never experienced any of these adverse childhood events.

Women who reported experiencing all of the negative childhood experiences were 11 times more likely to have had sex before age 15, seven times more likely to perceive themselves at risk for AIDS and 14 times more likely to have had more than 30 sex partners, compared with women who had experienced none of the adverse events.

"What you see here is the long-term impact of having lived in an unhealthy family,'' Hillis said. "These risk behaviors represent attempts to achieve intimacy that was not experienced during childhood, so people who grow up not taught intimacy are unprepared to protect themselves as adults.''

Hillis concludes society may be better off focusing on creating healthy and nurturing early environments rather than attempting to change learned behaviors after the fact.

"While safe sex messages may be useful, it appears that if you begin to address those behaviors after they've developed, it's hard to change them,'' she noted. "If we could focus on building healthy families, we may go further in preventing STDs and unintended pregnancies.''