Sex Disparities in Adverse Childhood Experiences and HIV/STIs: Mediation of Psychopathology and Sexual Behaviors

• Published in: AIDS and behavior 2017-06, Vol.21 (6), p.1550-1566
• Main Authors: Brown, Monique J., Masho, Saba W., Perera, Robert A., Mezuk, Briana, Pugsley, River A., Cohen, Steven A.
• Format: Article
• Language: English
• Subjects: Abuse; Acquired immune deficiency syndrome; Adult; Adverse childhood experiences; Aggression; AIDS; Alcoholic beverages; Child; Child Abuse - psychology; Child Abuse - statistics & numerical data; Child Abuse, Sexual - statistics & numerical data; Child sexual abuse; Childhood; Childhood factors; Children; Cross-Sectional Studies; Depressive Disorder, Major; Disorders; Domestic violence; Emotional abuse; Emotions; Epidemiology; Female; Gender aspects; Gender differences; Gender roles; Health behavior; Health Psychology; HIV; HIV Infections - psychology; Human immunodeficiency virus; Humans; Infectious Diseases; Intimate partner violence; Intimate Partner Violence - psychology; Life Change Events; Male; Mediation; Medicine; Medicine & Public Health; Men; Mens health; Mental depression; Middle Aged; Original Paper; Parents & parenting; Post traumatic stress disorder; Psychopathology; Public Health; Sex; Sex crimes; Sex differences; Sexual assault; Sexual behavior; Sexual Behavior - statistics & numerical data; Sexually transmitted diseases; Spouse Abuse - psychology; Spouse Abuse - statistics & numerical data; Statistical analysis; STD; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Structural equation modeling; Substance abuse; Substance use; Substance use disorder; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; United States; Violence; Women; Womens health; Young Adult
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-016-1553-0

HIV and other sexually transmitted infections (STIs) are important public health challenges in the US. Adverse childhood experiences (ACEs), including abuse (emotional, physical or sexual), witnessing violence among household members, may have an effect on sexual behaviors, which increase the risk of HIV/STIs. The aim of this study was to examine the sex differences in the role of posttraumatic stress disorder (PTSD), major depression (MD), substance use disorders (SUDs), early sexual debut, and intimate partner violence (IPV) perpetration as mediators in the association between ACEs and HIV/STIs. Data were obtained from Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the role of PTSD, MD, SUDs, early sexual debut, and IPV perpetration as mediators in the relationships between ACEs and HIV/STIs. Differences and similarities existed in the mediational roles of psychopathology and sexual behaviors. For example, among men, MD fully mediated physical/psychological abuse (β = 0.0002; p  = 0.012) and sexual abuse (β = 0.0002; p  = 0.006), and HIV/STIs while among women, MD fully mediated physical/psychological abuse (β = 0.0005; p