Childhood Sexual Abuse and Sexual Risk Behaviors among College Students in Appalachia

Background: Childhood Sexual Abuse (CSA) has been linked to a range of adult health problems. This study investigates the association between CSA and sexual risk behaviors of college students in Appalachia. Methodology: Students enrolled in introductory psychology courses at a four-year university in the Appalachian region participated in this survey in 2015. All analyses were completed in SAS. Among 995 participants, the average age was 20 and 69% were female. Simple and multivariate logistic regressions were completed for CSA to predict alcohol use before sex, self-reported diagnosis of Sexually Transmitted Diseases (STD), and unintended pregnancy. Age, gender, and other Adverse Childhood Experiences (ACEs) (physical, emotional, verbal abuse, substance abuse in family, family mental illness, and family incarceration) were considered as covariates. Only significant covariates were included in the final model. Results: In the unadjusted models, CSA was significantly associated with alcohol use before sex (OR=2.66, CI=1.62-4.38), risk of STD (OR=2.42, CI=1.12-5.21), and unintended pregnancy (OR=5.72, CI=3.12-10.50). Association between CSA and unintended pregnancy (OR=3.12, CI=1.60-6.08) was significant in the final model. CSA increased the odds of drinking alcohol before sex by 1.83 among females compared to males (CI=1.31-2.54). In the final model, verbal abuse was significantly associated with alcohol use before sex (OR=1.56, CI=1.1-2.22) and STD (OR=4.05, CI=2.11-7.75) while physical abuse was a significant predictor of unintended pregnancy (OR=2.14, CI=1.07-4.30). Conclusion: CSA increased the odds of some risky sexual behaviors among this college aged sample. However, the importance of other forms of ACEs also deserve further exploration.