The Effects of Trauma, Violence, and Stress on Sexual Health Outcomes Among Female Clinic Clients in a Small Northeastern U.S. Urban Center

Abstract

Background: Threats to sexual health can emerge across one's life span and are influenced by individual and interpersonal experiences, as well as certain environmental exposures. Although previous research has recognized the importance of ecological frameworks to understand the complexity of health and behaviors in marginalized communities, there continues to be a dearth of research that truly utilizes this perspective to gain insight into the multifaceted factors that can concurrently influence threats to sexual health among women. Methods: A sample of 279 ethnoracially diverse women were recruited from a U.S. northeastern small urban center health clinic to participate in a parent study on trauma and immunity. A hierarchical block analysis was conducted to investigate associations between women's experiences of trauma, stress and violence (i.e., childhood trauma (CHT), intimate partner violence (IPV), neighborhood stressors), and sexual health outcomes and behaviors (i.e., lifetime sexually transmitted infection [STI] diagnosis, concurrent partnerships, and lifetime sex trading). Results: In the full hierarchical model, IPV and life stress trauma were associated with lifetime sex trading and partner concurrency. Also in the full model, sexual CHT was associated with lifetime STI acquisition and partner concurrency, while emotional CHT was associated with lifetime sex trading. Lastly, as neighborhood disorder increased, so did the number of lifetime sex trading partners. Conclusion: Sexual health assessments in clinical and community settings require a holistic, comprehensive, and meaningful approach to inform person-centered health promotion intervention. Prevention and treatment interventions require a focus on parents and families, and should assist adolescents and young adults to adopt therapies for healing from these experiences of trauma, violence, and stress. Interventions to enhance sexual health promotion must also include the following: advocacy for safe environments, social policy that addresses lifelong impacts of CHT, and fiscal policy that addresses economic vulnerability among women and threatens sexual health. Further recommendations are discussed.

Association of Trauma History with Current Psychosocial Health Outcomes of Young African American Women

“…Women who have trauma history are over twice as likely to have multiple sex partners, perceive peer norms for risky sex, have lower communication frequency with partners about sexual boundaries, and have lower self-efficacy for refusing sex. This study adds to the literature showing that having a history of trauma may be associated with greater adverse interpersonal sexual communication and behaviors such as decreased condom use [54]. A history of trauma is not only associated with women's sexual health outcomes but is also associated with IPV [55].…”

Characterising a syndemic among black women at risk for HIV: the role of sociostructural inequity and adverse childhood experiences

“…In one of the few studies that examined racial differences, black women experienced five times more childhood maltreatment than white women 20. Childhood sexual abuse increased adult risk for lifetime STI acquisition, along with partner concurrency, emotional trauma and lifetime sex trading in a sample of 66% black women 21. Among young women who used marijuana, black women were more likely to engage in high-risk sexual behaviours and progress to marijuana use than white women 22.…”

“…20 Childhood sexual abuse increased adult risk for lifetime STI acquisition, along with partner concurrency, emotional trauma and lifetime sex trading in a sample of 66% black women. 21 Among young women who used marijuana, black women were more likely to engage in high-risk sexual behaviours and progress to marijuana use than white women. 22 Previous research found that each additional ACE reported among black women was associated with a 49% increased risk of experiencing very early sexual initiation at 11–12 years old.…”

Depressive and Sexual Disorders during the First and Second Wave of the COVID-19 Pandemic among Young Polish Women

“…Many scientists investigating mental health found a higher prevalence of depression, anxiety, insomnia and violence in the population during the outbreak of COVID-19, concluding that the pandemic harmed the mental health of the population [15,16]. Reports from the literature suggest a link between women's quality of life, sexual health and stressful events in their life [17,18]. The evidence on the impact of the COVID-19 pandemic on sexual behavior is growing [19].…”