A test of factors mediating the relationship between unwanted sexual activity during childhood and risky sexual practices among women enrolled in theNIMH multisite HIV prevention trial

This study examined both the direct and indirect associations between unwan ted sexual activity during childhood and HIV-related sexual practices of ad ult women. The sample consisted of 3,346 women recruited from sexually tran smitted disease (STD) clinics and health service organizations. The finding s demonstrated that participants who reported unwanted sexual activity as a child (USC) were more likely than women who did not report such experience to indicate that they had problems with alcohol, used drugs. received mone y or drugs in exchange for sex, had unwanted sex, and used mental health se rvices. The women reporting USC also noted a greater number of unprotected sex acts, a greater number of partners, and a greater proportion of sex act s accompanied by drugs or alcohol in the past 90 days. Mediated analyses sh owed that drug use, exchange of sex for money/drugs. unwanted sex, and to a lesser extent, problems with alcohol mediated the relationship between USC and unprotected sex acts, number of partners, and sex under the influence of drugs and alcohol. These Findings suggest that participation in non-sexu al risky behaviors among women who report USC may be a bridge to participat ion in sexual behaviors that increase their risk of HIV infection. (C) 2001 by The Haworth Press, Inc. All rights reserved.