Childhood and adolescent sexual abuse (CSA) is associated with a wide variety of adverse psychological and health outcomes, including negative sexual health outcomes. In this paper, we review the literature investigating the relation between CSA and subsequent sexual risk behaviors among men and women. Previous research has found a relatively consistent association between CSA and higher rates of sexual risk behaviors, particularly sex trading, more sexual partners, and an earlier age of first intercourse. However, there are a number of limitations to this research, including lack of a consistent definition of CSA, failure to investigate gender as a moderator, and possible confounding of the CSA experience with some of the sexual behavior outcome variables. Further, although there appears to be an association between CSA and later sexual risk behavior, researchers have not established whether this association is causal. Suggestions for future research and implications for clinical practice are discussed.The association between childhood and adolescent sexual abuse (CSA) and adverse psychological functioning has been well-documented, in both literature reviews (e.g., Beitchman, Zucker, Hood, daCosta, & Akman, 1991;Beitchman et al., 1992) and metaanalyses (e.g., Jumper, 1995;Paolucci, Genuis, & Violato, 2001). Recently, researchers have also documented an association between CSA and adverse health outcomes, including sexual health outcomes (e.g., Bartholow et al., 1994;Senn, Carey, Vanable, Coury-Doniger, & Urban, 2006). However, few systematic reviews of this literature have been undertaken. Thus, the purpose of this paper is to review the literature investigating the relation between CSA and subsequent sexual risk behavior, and to provide researchers with directions for future studies in this area. In this paper, we first review how CSA has been defined, and then review measures used to assess CSA. Next, we briefly summarize the mental health outcomes of CSA. The bulk of the paper examines findings from previous studies investigating the association between CSA and subsequent sexual behavior. Finally, we conclude by suggesting directions for future studies, and discussing practice implications.
Definition of CSAThe definition of CSA has varied widely across studies. First, researchers have used different age criteria for "childhood sexual abuse." Often, this term is used to refer to sexual abuse that Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Author ManuscriptClin Psychol Rev. Author manuscript; available in PMC 2009 June 1.
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