Skip to main content
Log in

The Relationship Between Sexual Abuse and Sexual Risk Among High School Students: Findings from the 1997 Massachusetts Youth Risk Behavior Survey

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objective: To assess whether adolescents with a history of sexual abuse were more likely than those with no such history to engage in sexual risk behaviors. Methods: Data for this study were obtained through the 1997 Massachusetts Youth Risk Behavior Survey, a self-report questionnaire administered to a representative sample of 9th through 12th graders (N = 4014) to assess a variety of adolescent risk behaviors. Only sexually experienced adolescents (n = 1610; female = 779, male = 831) were included in the present study. Logistic regression models were constructed to examine the relationship of sexual abuse history to sexual risk behaviors. Adolescents were considered as having a history of sexual abuse if they reported ever having had sexual contact against their will. Results: Almost one- third of sexually experienced adolescent girls (30.2%) and one-tenth (9.3%) of adolescent boys reported a history of sexual abuse. After controlling for related demographics and risk behaviors, sexually abused female students were significantly more likely than those without such a history to have had earlier first coitus (OR = 2.2, 95%CI = 1.46–3.47), to have had three or more sex partners ever (OR = 2.5, 95%CI = 1.71–3.68), and to have been pregnant (OR = 1.9, 95%CI = 1.21–2.92). Sexually abused male students were significantly more likely than those without such a history to have ever had multiple partners (OR = 3.2, 95%CI = 1.56–6.57), to have had multiple sex partners in the past 3 months (OR = 2.9, 95%CI = 1.71–3.68), and to have engaged in sex resulting in pregnancy (OR = 3.4,95%CI = 1.53–7.34). Conclusion: Both adolescent girls and boys with a history of sexual abuse report greater sexual risk-taking than those without such a history. However, although sexual abuse is more prevalent among girls than boys, the impact of sexual abuse on sexual risk appears to be even greater for boys. Programs addressing both sexual abuse and sexual risk must be made available to all adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Holmes WC, Slap G. Sexual abuse of boys: Definition, prevalence, correlates, sequelae, and management. JAMA 1998; 280(21):1855–62.

    Google Scholar 

  2. Wyatt GE, Loeb TB, Solis B, Carmona JV. The prevalence and circumstances of child sexual abuse: Changes across a decade. Child Abuse Negl 1999;23(1):45–60.

    Google Scholar 

  3. Nelson DE, Higginson GK, Grant-Worley JA. Using the Youth Risk Behavior Survey to estimate prevalence of sexual abuse among Oregon high school students. J School Health 1994;64(10):413–6.

    Google Scholar 

  4. Moss N. Behavioral risks for HIVin adolescents. Acta Paediatrica 1994(Suppl);400:81–7.

    Google Scholar 

  5. Trends in sexual risk behavior among high school students— United States, 1990, 1991, and 1993. MMWR 1995;44(7): 124–5, 131–2.

    Google Scholar 

  6. Bartholow BN, Doll LS, Joy D, Douglas JM, Bolan G, Harrison JS, Moss PM, McKirnan D. Emotional, behavioral, and HIV risks associated with sexual abuse among adult homosexual and bisexual men. Child Abuse Negl 1994;18(9):747–61.

    Google Scholar 

  7. Cunningham RM, Stiffman AR, Dore P, Earls F. The association of physical and sexual abuse with HIV risk behaviors in adolescence and young adulthood: Implications for health. Child Abuse Negl 1994;18(3):233–45.

    Google Scholar 

  8. Carballo-Dieguez A, Dolezal C. Association between history of childhood sexual abuse and adult HIV-risk sexual behavior in Puerto Rican men who have sex with men. Child Abuse Negl 1995;19(5):595–605.

    Google Scholar 

  9. Golding J. Sexual assault history and women's reproductive and sexual health. Psychol Women Q 1996;20:101–21.

    Google Scholar 

  10. Harlow LL, Rose JS, Morokoff PJ, Quina K, Mayer K, Mitchell K, Schnoll R. Women HIV sexual risk takers: Related behaviors, interpersonal issues, and attitudes. Women's Health 1998;4(4):407–39.

    Google Scholar 

  11. Irwin KL, Edlin BR, Wong L, Faruque S, McCoy HV, Word C, Schilling R, McCoy CB, Evans PE, Holmberg SD. Urban rape survivors: Characteristics and prevalence of human immunodeficiency virus and other sexually transmitted infections. Multicenter Crack Cocaine and HIV Infection Study Team. Obstet Gynecol 1995;85:330–6.

    Google Scholar 

  12. Lenderking WR, Wold C, Mayer KH, Goldstein R, Losina E, Seage GR. Childhood sexual abuse among homosexual men: Prevalence and associations with unsafe sex. JGen Intern Med 1997;12(4):250–3.

    Google Scholar 

  13. Plichta SB, Abraham C. Violence and gynecological health in women <50 years old. Am J Obstet Gynecol 1996; 174(3):903–7.

    Google Scholar 

  14. Thompson NJ, Potter JS, Sanderson CA, Maibach EW. The relationship of sexual abuse and HIV risk behaviors among heterosexual adult female STD patients. Child Abuse Negl 1997;21(2):149–56.

    Google Scholar 

  15. Zierler S, Feingold L, Laufer D, Velentgas P, Kantrowitz-Gordon I, Mayer K. Adult survivors of childhood sexual abuse and subsequent risk of HIV infection. Am J Public Health 1991;81:572–5.

    Google Scholar 

  16. Brown LK, Kessel SM, Lourie KJ, Ford HH, Lipsitt LP. Influence of sexual abuse of HIV-related attitudes and behaviors in adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry 1997;36(3):316–22.

    Google Scholar 

  17. Siegal RM, Schubert CJ, Myers PA, Shapiro RA. The prevalence of sexually transmitted diseases in children and adolescents evaluated for sexual abuse in Cincinnati: Rationale for limited STD testing in prepubertal girls. Pediatrics 1995;96(6):1090–4.

    Google Scholar 

  18. Mason WZ, Zimmerman L, Evans W. Sexual and physical abuse among incarcerated youth: Implications for sexual behavior, contraceptive use, and teenage pregnancy. Child Abuse Negl 1998;22(10):987–95.

    Google Scholar 

  19. Polit DF, White CM, Morton TD. Child sexual abuse and premarital intercourse among high-risk adolescents. JAdolesc Health Care 1990;11(3):231–4.

    Google Scholar 

  20. Bond LS, Mazin R, Jiminez MV. Street youth and AIDS. AIDS Educ Prev 1992 (Suppl):14–23.

  21. Johnson LS, Rozmus C, Edmisson K. Adolescent sexuality and sexually transmitted diseases: Attitudes, beliefs, knowledge and values. J Pediatr Nurs 1999;14(3):177–85.

    Google Scholar 

  22. Rotheram-Borus MJ, Mahler KA, Koopman C, Langabeer K. Sexual abuse history and associated multiple risk behavior in adolescent runaways. Am J Orthopsychiatry 1996; 66(3):390–400.

    Google Scholar 

  23. Brener ND, McMahon PM, Warren CW, Douglas KA. Forced sexual intercourse and associated health-risk behaviors among female college students in the United States. J Consult Clin Psychol 1999;67(2):252–9.

    Google Scholar 

  24. Fergusson DM, Horwood LJ, Lynskey MT. Childhood sexual abuse, adolescent sexual behaviors and sexual revictimization. Child Abuse Negl 1997;21(8):789–803.

    Google Scholar 

  25. Nagy S, DiClemente R, Adcock AG. Adverse factors associated with forced sex among southern adolescent girls. Pediatrics 1996;5(Pt 1):944–6.

    Google Scholar 

  26. Rickert VI, Wiemann CM. Date rape among adolescents and young adults. J Pediatr Adolesc Gynecol 1998;11(4): 167–75.

    Google Scholar 

  27. Erickson PI, Rapkin AJ. Unwanted sexual experiences among middle and high school youth. J Adolesc Health 1991; 12(4):319–25.

    Google Scholar 

  28. Chandy JM, Blum RW, Resnick MD. Gender-specific outcomes for sexually abused adolescents. Child Abuse Negl 1996;20(12):1219–31.

    Google Scholar 

  29. Shrier LA, Pierce JD, Emans SJ, DuRant RH. Gender differences in risk behaviors associated with forced or pressured sex. Arch Pediatr Adolesc Med 1998;152:57–63.

    Google Scholar 

  30. Pierre N, Shrier LA, Emans SJ, DuRant RH. Adolescent males involved in pregnancy: Associations of forced sexual contact and risk behaviors. J Adolesc Health 1998;23(6): 364–9.

    Google Scholar 

  31. Moncrieff J, Drummond DC, Candy B, Checinski K, Farmer R. Sexual abuse in people with alcohol problems. A study of the prevalence of sexual abuse and its relationship to drinking behavior. Br J Psychiatry 1997;169(3):355–60.

    Google Scholar 

  32. Davidson JR, Hughes DC, George LK, Blazer DG. The association of sexual assault and attempted suicide within the community. Arch Gen Psychiatry 1996;53(6):550–5.

    Google Scholar 

  33. Fortenberry JD. Number of sexual partners and health lifestyle of adolescents. Use of the AMA Guidelines for Adolescent Preventive Services to address a basic research question. Arch Pediatr Adolesc Med 1996;151(11):1139–43.

    Google Scholar 

  34. Galambos NL, Tilton-Weaver LC. Multiple risk behavior in adolescents and young adults. Health Rep 1998;10(2):9–20.

    Google Scholar 

  35. Lowry R, Holtzman D, Truman BI, Kann L, Collins JL, Kolbe LJ. Substance use and HIV-related sexual behaviors among US high school students: Are they related? AmJ Public Health 1994;84(7):1116–20.

    Google Scholar 

  36. Orr DP, Beiter M, Ingersoll G. Premature sexual activity as an indicator of psychosocial risk. Pediatrics 1991;87(2):141–7.

    Google Scholar 

  37. Rome ES, Rybicki LA, DuRant RH. Pregnancy and other risk behaviors among adolescent girls in Ohio. J Adolesc Health 1998;22(1):50–5.

    Google Scholar 

  38. Santelli JS, Brener ND, Lowry R, Bhatt A, Zabin LS. Multiple sex partners among US adolescents and young adults. Fam Plann Perspect 1998;30(6):271–5.

    Google Scholar 

  39. Shrier LA, Emans SJ, Woods ER, DuRant RH. The association of sexual risk behaviors and problem drug behaviors in high school students. J Adolesc Health 1997;20(5):377–83.

    Google Scholar 

  40. Spingarn RW, DuRant RH. Male adolescents involved in pregnancy: Associated health risk and problem behaviors. Pediatrics 1996;98(2 Pt 1):262–68.

    Google Scholar 

  41. Staton M, Leukefeld C, Logan TK, Zimmerman R, Lynam D, Milich R, Martin C, McClanahan K, Clayton R. Risk sex behavior and substance use among young adults. Health Soc Work 1999;24(2):147–54.

    Google Scholar 

  42. DuRant RH, Knight J, Goodman E. Factors associated with aggressive and delinquent behaviors among adolescents attending an adolescent medicine clinic. J Adolesc Health 1997;21(5):303–8.

    Google Scholar 

  43. Orpinas PK, Basen-Enquist K, Grunbaum JA, Parcel GS. The co-morbidity of violence-related behaviors with healthrisk behaviors in a population of high school students. J Adolesc Health 1995;16(3):216–25.

    Google Scholar 

  44. Sosin DM, Koepsell TD, Rivara FP, Mercy JA. Fighting as a marker for multiple problem behaviors in adolescents. J Adolesc Health 1995;16(3):209–15.

    Google Scholar 

  45. Valois RF, McKeown RE, Garrison CZ, Vincent ML. Correlates of aggressive and violent behaviors among public high school students. J Adolesc Health 1995;16(1):26–34.

    Google Scholar 

  46. Adcock AG, Nagy S, Simpson JA. Selected risk factors in adolescent suicide attempts. Adolescence 1991;26(104): 817–28.

    Google Scholar 

  47. Burge V, Felts M, Chenier T, Parrillo AV. Drug use, sexual activity, and suicidal behavior in U.S. high school students. J School Health 1995;65(6):222–7.

    Google Scholar 

  48. Lechner ME, Vogel ME, Garcia-Shelton LM, Leichter JL, Steibel KR. Self-reported medical problems of adult female survivors of childhood sexual abuse. J Fam Pract 1993; 36(6):633–8.

    Google Scholar 

  49. Kalton G. Sampling considerations in research on HIV risk and illness. In: Ostrow DG, Kessler RC, editors. Methodological issues in AIDS behavioral research. New York: Plenum Press, 1993:53–74.

    Google Scholar 

  50. Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics 1998;101(5):895–902.

    Google Scholar 

  51. Hunter J, Rosario M, Rotheram-Borus MJ. Sexual and substance abuse acts that place adolescent lesbians at risk for HIV. In: International Conference on AIDS, Vol. 9(2). Berlin, 1993:790 (Abstract no. PO-D02-3432).

    Google Scholar 

  52. Wren PA, Janz NK, Carovano K, Zimmerman MA, Washienko KM. Preventing the spread of AIDS in youth: Principles of practice from 11 diverse projects. J Adolesc Health 1997;21(5):309–17.

    Google Scholar 

  53. Misovich SJ, Fisher JD, Fisher WA. Close relationships and elevated HIV risk behavior: Evidence and possible underlying psychological processes. Rev Gen Psychol 1997;1(1):72–107.

    Google Scholar 

  54. Raj A. Identification of social cognitive variables as predictors of safer sex behavior and intent in heterosexual college students. J Sex Marital Ther 1996;22(4):247–58.

    Google Scholar 

  55. Finklehor D. Boys as victims: Review of the evidence. In: Finkelhor D, Yllo K, editors. Childhood sexual abuse: New theory and research. New York: Free Press, 1984;150–70.

    Google Scholar 

  56. Rentoul L, Appleboom N. Understanding the psychological impact of rape and serious sexual assault of men. A literature review. J Psychiatric Ment Health Nurs 1997;4(4):267–74.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Raj, A., Silverman, J.G. & Amaro, H. The Relationship Between Sexual Abuse and Sexual Risk Among High School Students: Findings from the 1997 Massachusetts Youth Risk Behavior Survey. Matern Child Health J 4, 125–134 (2000). https://doi.org/10.1023/A:1009526422148

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1009526422148

Navigation