Childhood Sexual/Physical Violence, Alcohol Use, Depressive Symptoms, and Indiscriminant Sexual Behaviors of Young White and African American Women: A Multigroup Structural Equation Modeling Approach

Purpose: Little is known about the mechanisms by which childhood sexual/physical violence increases the likelihood of indiscriminant sexual behaviors in adulthood among women. Understanding of the effects of alcohol use and depressive symptoms on the relationship between childhood sexual/physical violence and indiscriminant sexual behaviors is also limited. Research that examines racial/ethnic differences on the mechanisms is even scarcer. The purpose of this study was to examine the relationship between childhood sexual/physical violence and indiscriminant sexual behaviors, with alcohol use and depressive symptoms as mediators and to examine racial/ethnic differences in the proposed relationships.

Methods: From the 2007-2008 National Longitudinal Study of Adolescent Health, 1,388 sexually active women (1,021 non-Hispanic White (White) and 367 non-Hispanic African American (African American) women) were included in the study. Structural equation modeling (SEM) and multigroup SEM were used to test pathways between experiences of childhood sexual/physical violence and indiscriminant sexual behaviors and to examine differences in path coefficients and factor loadings between White and African American women. Childhood sexual/physical violence was defined as any experiences of sexual or physical violence before respondents’ 18^th birthday. Alcohol use, a latent factor, was measured by six ordinal items; two times of drinking frequency (binge drinking episodes and episodes of getting drunk) and four items of alcohol related problems during the past 12 months. Depressive symptoms, another latent factor, was measured by the 11-item version of the Center for Epidemiologic Studies Depression Scale (α=.84). Respondents’ age, marital status, education attainment, and personal income were included as covariates.

Findings: In the SEM, alcohol use and depressive symptoms mediated the relationship between childhood sexual/physical violence and indiscriminant sexual behaviors (indirect effect=.16 X .26=.04, p <.05; indirect effect=.26 X .15=.04, p <.001, respectively). From the multigroup SEM, White and African American women showed different structures in the proposed associations and different magnitudes on path coefficients and factor loadings. For White women, both alcohol use and depressive symptoms mediated the association between childhood sexual or physical violence and indiscriminant sexual behaviors (indirect effect=.08 X .33=.03, p <.05; indirect effect=.28 X .16=.04, p <.001, respectively), while only depressive symptoms mediated the proposed association for African American women (Indirect effect=.18 X .29=.05, p <.001). In addition, this study found that African American women showed significantly greater path coefficient in the association between childhood sexual/physical violence and alcohol use (Δχ² (1, 1,388) = 6.15, p <.05) and significantly greater factor loadings on levels of depressive symptoms than White women.

Conclusion: This study adds to the literature on risk factors associated with indiscriminant sexual behaviors and effectively illustrates the vulnerability of survivors of childhood sexual/physical violence for having multiple sexual partners. This study highlights the importance of providing effective and targeted treatment for women with childhood sexual or physical violence experiences in order to limit negative consequences they experience. This study also adds to the literature by increasing the understanding of racial/ethnic differences. Effective and targeted screening, culturally competent interventions, and referrals are also necessary.