Adverse childhood experiences and sexually transmitted diseases in men andwomen: A retrospective study

Objective. Adverse childhood experiences (ACEs) may have long-term conseque nces on at-risk behaviors that lead to an increased risk of sexually transm itted diseases (STDs) during adulthood. Therefore, we examined the relation ship between ACEs and subsequent STDs for both men and women. Methods. A total of 9323 (4263 men and 5060 women) adults greater than or e qual to 18 years of age participated in a retrospective cohort study evalua ting the association between ACEs and self-reported STDs. Participants were adult members of a managed care organization who underwent routine medical evaluations and completed standardized questionnaires about 7 categories o f ACEs, including emotional, physical, or sexual abuse; living with a batte red mother; and living with a substance-abusing, mentally ill, or criminal household member. Logistic regression was used to model the association bet ween the cumulative categories of ACEs (range: 0-7) and a history of STDs. Results. We found that 59% (2986) of women and 57% (2464) of men reported 1 or more categories of adverse experiences during childhood. Among those wi th 0, 1, 2, 3, 4 to 5, and 6 to 7 ACEs, the proportion with STDs was 4.1%, 6.9%, 8.0%, 11.6%, 13.5%, and 20.7% for women and 7.3%, 10.9%, 12.9%, 17.1% , 17.1%, and 39.1% for men. After adjustment for age and race, all odds rat ios for reporting an STD had confidence intervals that excluded 1. Among th ose with 1, 2, 3, 4 to 5, and 6 to 7 ACEs, the odds ratios were 1.45, 1.54, 2.22, 2.48, and 3.40 for women and 1.46, 1.67, 2.16, 2.07, and 5.3 for men . Conclusions. We observed a strong graded relationship between ACEs and a se lf-reported history of STDs among adults.