Childhood sexual abuse and revictimization in adolescence.

OBJECTIVE: The aim of this study was to examine the link between childhood experiences of sexual abuse and subsequent revictimization in adolescence. METHOD: A sample of 281 female adolescents between 17-20 years of age, who participated in a prevalence survey of unwanted sexual contacts, completed the Sexual Experiences Survey as a measure of unwanted sexual contacts in adolescence and indicated whether or not they had experienced childhood sexual abuse. RESULTS: Childhood experiences of sexual abuse were reported by 8.9% of the respondents, a further 8.5% indicated they were not sure if they had been sexually abused as children. Both abused women and women uncertain about their victimization status were significantly more likely to report unwanted sexual contacts as adolescents than women who did not state abuse. The link between childhood abuse and subsequent victimization was mediated by a higher level of sexual activity among the abuse victims. CONCLUSIONS: The results support existing evidence on the impact of childhood sexual abuse on sexual relationships in subsequent developmental stages and underline the need to consider childhood sexual abuse as a risk factor of adolescent sexual victimization.     

Child sexual abuse prevention programs: do they decrease the occurrence of child sexual abuse?

OBJECTIVE: The primary goal of the current study was to determine whether rates of child sexual abuse differed among undergraduate women who either had or had not participated in a sexual abuse prevention program during childhood. A secondary goal was to determine whether differences emerged in sexual satisfaction or avoidance of sexual activity between those women who had or had not participated in such a program. METHOD: Eight hundred and twenty-five women undergraduates from a New England state university filled out a survey on "sexual experiences" for research credit. Respondents were asked detailed questions regarding past histories of child sexual abuse and participation in school-based prevention programs during childhood. Additionally, they responded to questions about their current sexual satisfaction and sexual behaviors. RESULTS: Sixty-two percent of the sample reported having participated in a "good touch-bad touch" sexual abuse prevention program in school. Eight percent of respondents who reported ever having had a prevention program also reported having been subsequently sexually abused, compared to 14% of respondents who did not ever have a prevention program. No differences were found in adult sexual satisfaction or on behavioral measures of sexual activity between those respondents who had and had not participated in a prevention program. CONCLUSIONS: This is the first study to find that school-based child sexual abuse prevention programs are associated with a reduced incidence of child sexual abuse. Additionally, contrary to concerns voiced in the literature, there was no evidence that prevention programs are associated with decreased sexual satisfaction or avoidance of sex in adulthood. Implications of the results for further study are discussed.     

The impact of perceived childhood victimization and patriarchal gender ideology on intimate partner violence (IPV) victimization among Korean immigrant women in the USA

Childhood victimization experiences are common among intimate partner violence (IPV) victims. This study examines the link between childhood physical and sexual victimization experiences and adulthood IPV among Korean immigrant women in the USA. As Korean immigrants often use physical punishment to discipline their children, and reporting sexual abuse is discouraged due to stigmatization in this community, cultural factors (e.g. patriarchal values) related to childhood victimization and IPV were also examined. Survey data from Korean immigrant women in the USA were collected. Using a case-control design, we compared 64 Korean immigrant women who have experienced IPV in the past year with 63 Korean immigrant women who have never experienced IPV in their lifetime. The findings of this study reveal that IPV victims, compared with non-victims, experienced higher childhood victimization rates. Logistic regression analysis demonstrated that childhood victimization and patriarchal gender ideology strongly predict IPV victimization among Korean immigrants. However, patriarchal values did not moderate the relationship between childhood victimization and IPV. To prevent IPV among Korean immigrant population, we need to make special efforts to prevent childhood abuse and change ingrained cultural attitudes about child physical and sexual abuse among immigrant communities through culturally sensitive programs.     

Perpetrators of early physical and sexual abuse among homeless and runaway adolescents

OBJECTIVE: To examine abuse specific variables among homeless and runaway adolescents and to look at perpetrators of childhood abuse. METHOD: A total of 372 homeless and runaway adolescents were interviewed using a systematic sampling strategy in metropolitan Seattle. Young people were interviewed on the streets and in shelters by outreach workers in youth service agencies. RESULTS: Approximately one-half of these young people reported being physically abused and almost one-third experienced sexual abuse. Females experienced significantly higher rates of sexual abuse compared to males, and sexual minority youth experienced significantly higher rates of physical and sexual abuse compared to heterosexual youth. Average duration of physical and sexual abuse was 5 and 2 years, respectively. Both types of abuse were rated as extremely violent by more than half of those who were abused. The average number of different perpetrators of physical and sexual abuse was four and three, respectively. Biological parents were the majority of perpetrators for physical abuse whereas nonfamily members most often perpetrated sexual abuse. Average age of perpetrators was late 20s to early 30s and the majority of perpetrators were male for both types of abuse.CONCLUSIONS: The pattern of exploitation and victimization within the family may have serious and cumulative developmental consequences for these youth as they enter the street environment. Early intervention programs are needed to break the cycle of exploitation and abuse that adolescents experience within the family. Without intervention, many of these youth may be at risk of future exploitation and re-victimization out on the street.     

Clinical features of survivors of sexual abuse with major depression.

OBJECTIVE: This study examined differences in rates of trauma-related disorders between patients with histories of childhood sexual abuse and those without such histories in a sample of depressed outpatients. Another aim of this study was to determine whether childhood sexual abuse is associated with recent suicidal attempts, affect dysregulation and duration of index depressive episode, independent of posttraumatic stress disorder and borderline personality disorder. METHOD: Subjects were 235 treatment-seeking outpatients with major depression. Structured interviews were administered to assess for Axis I and Axis II disorders, childhood sexual abuse, and various clinical features. RESULTS: Patients with sexual abuse compared to those without sexual abuse histories had higher rates of comorbidity, primarily borderline personality disorder, posttraumatic stress disorder and multiple Axis I diagnoses. Childhood sexual abuse status was linked to a longer duration of the index depressive episode, independent of borderline personality disorder and/or posttraumatic stress disorder. However, childhood sexual abuse status was not independently related to affect dysregulation and suicidal attempts. CONCLUSION: The findings suggest that patients with histories of sexual abuse represent a subgroup of depressed patients who are at especially high risk for psychiatric morbidity and a prolonged episode of depression.     

Intergenerational transmission of child abuse: Predictors of child abuse potential among racially diverse women residing in domestic violence shelters

Parental risk for perpetrating child abuse is frequently associated with intergenerational patterns of abuse: being abused increases the risk for future abuse. Yet, the mechanisms of intergenerational abuse are unclear, and the risk factors for perpetrating child abuse are interrelated. Research suggests that history of childhood abuse, psychiatric distress, and exposure to intimate partner violence (IPV) are all related risk factors for perpetrating child abuse. We investigated these three risk factors using the developmental psychopathology framework in a racially diverse sample of high-risk women: women residing in domestic violence shelters. 211 mothers residing in domestic violence shelters completed measures of their own childhood abuse (defined narrowly in a 10-item self-report survey), exposure to and severity of IPV victimization, and structured interviews to diagnose psychiatric disorders. We utilized a hierarchical regression model to predict child abuse potential, accounting for risk factors in blocks roughly representing theorized temporal relationships: childhood abuse followed by psychiatric diagnoses, and then recency of exposure to IPV. Consistent with hypotheses, the strongest predictor of current child abuse potential was the psychiatric diagnosis of PTSD. Mediation tests further explicated that the relationship between maternal history of childhood sexual abuse and current potential for perpetrating child abuse is mediated by IPV-related PTSD symptoms. Results suggest that IPV-related PTSD symptoms, rather than exposure to abuse (i.e., childhood abuse or IPV), is most strongly associated with child abuse potential in recent IPV survivors. Interventions which can ameliorate maternal psychopathology and provide resources are recommended for these vulnerable families.     

Childhood victimization and lifetime revictimization

OBJECTIVE: To examine the fundamental hypothesis that childhood victimization leads to increased vulnerability for subsequent (re)victimization in adolescence and adulthood and, if so, whether there are differences in rates of experiencing traumas and victimizations by gender, race/ethnicity, and type of childhood abuse and/or neglect. METHODS: Using a prospective cohort design, participants are individuals with documented cases of childhood physical and sexual abuse and neglect from the years 1967 through 1971 and a matched control group. Both groups were interviewed in-person (mean age 39.5 years) in 2000-2002 using a new instrument to assess lifetime trauma and victimization history. RESULTS: Abused and neglected individuals reported a higher number of traumas and victimization experiences than controls and all types of childhood victimization (physical abuse, sexual abuse, and neglect) were associated with increased risk for lifetime revictimization. Significant group (abuse/neglect vs. control) by gender and group by race/ethnicity interactions were found. Childhood victimization increased risk for physical and sexual assault/abuse, kidnapping/stalking, and having a family friend murdered or commit suicide, but not for general traumas, witnessing trauma, or crime victimization. CONCLUSIONS: These findings provide strong support for the need for early intervention with abused and neglected children and their families to prevent subsequent exposure to traumas and victimization experiences.     

The process of victimization: the victims' perspective

Twenty-three child victims (aged 10-18 years) of childhood sexual abuse were interviewed about the victimization process, the person who abused them, and how abuse might have been prevented. Specific questions obtained information about the quality of the relationship between victim and offender, the offender's pre-abuse behavior, the explanation for the behavior given by the offender, and the child's understanding of the behavior. Results suggest that the victimization process involves three overlapping processes: sexualization of the relationship, justification of the sexual contact, and maintenance of the child's cooperation.     

Posttraumatic stress mediates the relationship between childhood victimization and current mental health burden in newly incarcerated adults

The purpose of this study was to evaluate the interrelationship among childhood abuse and traumatic loss, posttraumatic stress symptoms (PTSS), and Axis I psychiatric disorders other than PTSD among newly incarcerated adults, and to test a proposed model in which the severity of PTSS mediates the relationship between childhood abuse/loss and adult psychiatric disorders. Four hundred sixty-five male and female inmates participated in a structured clinical research interview. Four types of interpersonal potentially traumatic experiences (physical abuse, sexual abuse, emotional abuse, and traumatic loss) were assessed for occurrence prior to the age of 18 years old. Current psychiatric disorders and PTSS were also assessed by structured interview. Negative binomial regression was used to evaluate the association between the cumulative number of types of childhood abuse/loss experienced and number of current Axis I disorders, and to test the mediation model. Approximately half of the sample (51%) experienced 1 or more types of childhood abuse/loss, and 30% of the sample had at least one psychiatric disorder other than PTSD. For both men and women, childhood physical abuse and childhood sexual abuse were independently associated with psychiatric morbidity, and an increasing number of types of childhood trauma experienced was associated with an increase in the number of current Axis I diagnoses. However, these associations were no longer statistically significant when severity of PTSS was added to the model, providing support for the proposed mediation model. Implications for secondary prevention services for at-risk inmates are discussed.     

Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample

OBJECTIVE: Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis. METHODS: Data are drawn from a follow-up of the Isle of Wight study, an epidemiological sample assessed in adolescence and at midlife. Ratings of psychiatric disorder, peer relationships and family functioning were made in adolescence; adult assessments included a lifetime psychiatric history, personality and social functioning assessments, and retrospective reports of childhood sexual and physical abuse. RESULTS: Ten percent of individuals reported repeated or severe physical or sexual abuse in childhood. Prospective measures revealed increased rates of adolescent psychiatric disorders in this group. Rates of adult psychopathology were also high. A substantial minority of abused individuals reported no mental health problems in adult life. Resilience of this kind was related to perceived parental care, adolescent peer relationships, the quality of adult love relationships, and personality style. CONCLUSION: Good quality relationships across childhood, adolescence and adulthood appear especially important for adult psychological well being in the context of childhood abuse.     

Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women

OBJECTIVE: This study examined the prevalence and psychological sequelae of childhood sexual and physical abuse in adults from the general population. METHOD: A national sampling service generated a geographically stratified, random sample of 1,442 subjects from the United States. Subjects were mailed a questionnaire that included the Traumatic Events Survey (TES) [Traumatic Events Survey, Unpublished Psychological Test, Harbor-UCLA Medical Center, Los Angeles] and the Trauma Symptom Inventory (TSI) [Trauma Symptom Inventory Professional Manual, Psychological Assessment Resources, Odessa, FL]. Of all potential subjects, 935 (64.8%) returned substantially completed surveys. RESULTS: Sixty-six men and 152 women (14.2% and 32.3%, respectively) reported childhood experiences that satisfied criteria for sexual abuse, and 103 males and 92 females (22.2% and 19.5%, respectively) met criteria for physical abuse. Twenty-one percent of subjects with one type of abuse also had experienced the other type, and both types were associated with subsequent adult victimization. After controlling for demographics, adult history of interpersonal violence, and other child abuse, childhood sexual abuse was associated with all 10 scales of the TSI, and physical abuse was related to all TSI scales except those tapping sexual issues. Sexual abuse predicted more symptom variance than did physical abuse or adult interpersonal victimization. Various aspects of both physical and sexual abuse experiences were predictive of TSI scores. Abuser sex, however, both alone and in interaction with victim sex, was not associated with additional TSI symptomatology. CONCLUSIONS: Childhood sexual and physical abuse is relatively common in the general population, and is associated with a wide variety of psychological symptoms. These relationships remain even after controlling for relevant background variables.     

Preventing sexually abused young people from becoming abusers,and treating the victimization experiences of young people who offend sexually

OBJECTIVE: This study was designed to determine whether it is possible to prevent those sexually abused boys who are at risk of abusing other children from doing so, and to assess whether factors associated with an experience of sexual abuse in young people who are offending can be dealt with as a key aspect of therapeutic work alongside treatment of offending behavior. METHOD: The author examined cross-sectional and longitudinal research which demonstrates the impact on sexually abused children of living in a climate of violence, suffering physical abuse, exposure to abuse of maternal figures, and suffering disruption and poor quality of care and supervision. These factors are confirmed in prospective research. RESULTS: The application of these findings to therapeutic programs for boys who are sexually abused is described, including the assessment of care needs as well as the specific therapeutic work with the young person, and work to modify the family context. The specific treatment of victimization experiences in young people who have committed sexual offenses is also examined, with recommendations for modification of treatment approaches suggested. CONCLUSION: It is vital in therapeutic work with boy victims of sexual abuse that the issue of their abusive potential be considered, even if a relatively small proportion of such boys will go on to abuse others. Given that boys who do sexually abuse are likely to have grown up in a climate of violence and poor care, methods of dealing with such victimization experiences need to be developed alongside offending focused treatments.     

Childhood adversity and adult depression among the incarcerated: Differential exposure and vulnerability by race/ethnicity and gender

The relationship between childhood adversity and adult depression is well-established but less is known about the association between childhood adversity and adult depression among the incarcerated. In this paper, we examine differential exposure and vulnerability to childhood adversity by race/ethnicity and gender on adult depression among the incarcerated in the United States. We address three research questions: does exposure to childhood adverse experiences vary by race/ethnicity and gender? Is there an association between these childhood adverse events and depression and does the strength of the association vary by the specific adverse experiences? And does vulnerability to childhood adversity vary by gender and race/ethnicity? Using the 2004 Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF), we measure four key childhood adverse events – parental/caretaker substance abuse, physical assault, having been placed in foster care, and sexual assault. We use ordinary least squares regression and a series of interaction effect analyses to examine differential exposure and vulnerability to the four childhood adverse experiences by race/ethnicity and gender. Incarcerated women are more likely to report parental substance abuse, but all inmates/prisoners are similarly vulnerable to this experience. For the other three adverse experiences measured, we find that there are important racial/ethnic and gender differences in both exposure and vulnerability. African American men and women are more vulnerable to the effects of physical and sexual victimization than White and Hispanic men and women. Women are much more likely to be exposed to sexual victimization, but men who report this experience are significantly more depressed. Hispanic women and White men and women are more likely to report foster care, but all inmates/prisoners who report foster care experiences are significantly more depressed than other inmates/prisoners, with the exception of white men. The findings indicate that there are significant differences in exposure and vulnerability to childhood adversity by race/ethnicity and gender. We conclude that in order to effectively design and implement programs to decrease the probability that childhood adversity is a risk factor for adult depression interventions must be targeted toward specific, vulnerable groups according to race/ethnicity and gender.     

Violence among family members of children and adolescents evaluated for sexual abuse

OBJECTIVES: The two aims of this study were to: (1). describe the prevalence and characteristics of domestic adult and child physical violence in the homes of children and adolescents evaluated in a specialized sexual abuse clinic and (2). describe parent or caretaker responses to domestic adult and child violence and child sexual abuse, including tendencies to report or seek medical care. METHOD: A consecutive sample of 164 subjects (ages 7-19) were interviewed in a sexual abuse clinic regarding in-home violent or abusive experiences among family members that had occurred at any time during their childhood. RESULTS: Fifty-two percent of these children and teenagers reported spousal violence in their home. Fifty-eight percent of child sexual offenders who were in-home males also physically abused their adult female partner. Half of in-home males who were physically violent to children also sexually abused them. In 86% of homes with partner violence, the children were also physically assaulted. There was no difference in sexual abuse disclosure rates or patterns for children living with or without adult violence. CONCLUSIONS: Sexually abused children should be questioned about physical abuse and the presence of violence among adults in their home. Safety plans for sexually abused children should incorporate screening for family violence and safety plans for parents and siblings of child victims, when appropriate.     

Self-defining as sexually abused and adult sexual risk behavior: results from a cross-sectional survey of women attending an STD clinic

Objective

Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as having experienced CSA despite meeting objective criteria that CSA occurred. This study sought to determine whether individuals who met research criteria for CSA and who self-defined as sexually abused differed on traumagenic dynamics constructs and current sexual risk behavior from individuals who met research criteria for CSA and who did not self-define as sexually abused.

Methods

Participants were 481 women recruited from a publicly funded STD clinic. Participants completed a computerized survey assessing childhood sexual experiences and adult sexual risk behavior.

Results

Of the total sample, 206 (43%) met research criteria for CSA. Of the women meeting research criteria for CSA, 142 (69%) self-defined as sexually abused. Women who met research criteria for CSA reported more traumatic sexualization, more trust of a partner, more powerlessness, less sexual guilt, more episodes of unprotected sex, more sex partners, and greater likelihood of sex trading, compared to women who did not meet research criteria for CSA. Among women meeting research criteria, those who self-defined as sexually abused did not differ from those who did not self-define on any of the traumagenic dynamics constructs or on current sexual risk behavior, controlling for CSA characteristics.

Conclusions

Individuals who were sexually abused as children by behavioral research criteria are at risk for engaging in sexual risk behavior as adults, regardless of whether or not they perceive the experience to be CSA. Future research is needed to understand how non-definers perceive these childhood sexual experiences.     

Childhood sexual experiences with an older partner among men who have sex with men in Buenos Aires,Argentina

This study sought to describe childhood sexual experiences with older partners (CSEOP) among men who have sex with men (MSM) in Buenos Aires, Argentina. MSM were recruited through respondent driven sampling. They responded to a computer administered self-interview with questions on CSEOP, operationalized as manual, oral, genital, or anal contact prior to age 13 with a partner at least 4 years older. Of the 500 respondents, only 25% identified as gay. Eighteen percent of the respondents reported CSEOP, the majority of whom did not feel they were hurt by the experience and did not consider it to be childhood sexual abuse (CSA). Over two-thirds of MSM who reported CSEOP said that their older partner was a female. Only 4% of those with a female partner felt their experience was CSA compared to 44% of those who had a male partner. Among all men reporting CSEOP, those who felt sexually abused were more likely to have been physically forced or threatened, physically hurt, and emotionally hurt than those who did not feel sexually abused. Having CSEOP, being hurt by the experiences, and perceiving the experiences as sexual abuse were not associated with current HIV sexual risk or substance use behavior. In this sample of MSM in Argentina, a substantial minority reported CSEOP. Those who felt they had been sexually abused were much more likely to have had an older male partner than an older female partner, and were more likely to report having been physically forced and threatened by their older partner.     

Child abuse: A study of the child''s perspective

This study ascertained the child's response to various types of abuse and neglect. With interviews and questionnaires for the staff of a child psychiatric unit, the mothers and the children involved, we assessed the severity, frequency and duration of physical abuse, verbal abuse, physical neglect, emotional neglect or sexual abuse of children. The physically abused children accepted blame for mild but not severe mistreatment. Verbally and sexually abused children did not believe it was their fault if the mistreatment was moderately extensive but did if it was mild or severe. The relationship between extent of abuse and blame was less clear for neglect, but children usually though it was their fault. Verbal and sexual abuse appeared to have a greater impact on the children's perception of themselves and the world. Verbally abused children were more angry and more pessimistic about their future. Although physical abuse appeared to make some children feel they were unwanted at birth, how much the mother wanted her children was not related to the extent of any type of abuse. Both the type and extent of mistreatment appear to have different effects on the child's subjective experience. The use of the visual analogue scale in this study made it possible to differentiate a continuum of severity and frequency of five types of mistreatment without the need for definition.     

Child peer sexual abuse: preliminary data on outcomes and disclosure experiences

OBJECTIVE: This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure. METHOD: An archival data set containing retrospective reports of childhood sexual experiences was culled for instances of sexual abuse by child peers and adolescents/adults. An equivalent nonabused comparison group was identified. The Self-Report Outcome Checklist (SROC; Gilbert, 1994b), the MMPI-Hugo Short Form (Hugo, 1971) and a disclosure survey were also retrieved from these data. RESULTS: Compared to abuse by peers, abuse perpetrated by adolescents/adults was more intrusive and intrafamilial. Both groups rated their experiences as equally negative, and reported equally pervasive outcomes. Those abused by adolescents/adults reported significantly higher scores on the Psychopathic Deviate, Psychasthenia, and Schizophrenia scales compared to nonabused controls; similar findings did not emerge for those abused by child peers. Less than a fourth in either abuse group reported disclosing their experience to a parent. Among those who did not disclose, participants abused by child peers anticipated less support from both parents and more anger from their mothers. CONCLUSIONS: The findings suggest that child peer sexual abuse may be associated with adverse outcomes.     

Childhood abuse, chronic pain, and depression in the National Comorbidity Survey

OBJECTIVE: The current study examined the effects of childhood sexual and physical abuse on reports of pain in men and women (N=1,727). METHODS: Data from the National Comorbidity Survey, a nationally representative sample, were utilized. Childhood experiences of physical and sexual abuse were assessed, and pain reports in relation to current health problems were obtained. Regression and mediation analyses were used to examine the relationship between childhood abuse and current pain reports and to determine whether depression mediated this relationship. RESULTS: Individuals who experienced abuse reported more health problems compared to those participants without abuse histories. Among participants with a current health problem, those who experienced abuse reported more pain compared to those participants without abuse histories. Because childhood abuse is associated with depression and depression is associated with more reported pain, the influence of depression on the relationship between childhood abuse and adult pain reports was examined. After controlling for differences between the abused and non-abused participants on specific health problems, depression was not found to have mediated the relationship. CONCLUSIONS: Childhood abuse was associated with more reported pain. The higher rate of depression found among adults who experienced childhood abuse was not the primary factor for these increased pain reports. Rather, childhood abuse and depression independently contributed to pain reports. Treatment of both underlying problems (i.e., pain and depression) is recommended in addressing the needs of abused individuals with these comorbid disorders.     

Relationships between childhood abuse and neglect experience and HIV risk behaviors among methadone treatment drop-outs

OBJECTIVE: The purpose of this study was to examine the relationships between childhood abuse/neglect experiences (sexual abuse, physical abuse, emotional abuse, and child neglect) and adult life functioning among Methadone Maintenance Treatment Program (MMTP) drop-outs. METHOD: 432 subjects who dropped out of MMTP were recruited in New York City in 1997-1999. Adult life functioning was measured by HIV drug and sex risk behaviors, Addiction Severity Index (ASI) composite scores, and depression. The chi(2) tests, t tests, correlation, and multiple logistic regressions were performed to examine the relationships between abuse experiences and adult life functioning. RESULTS: The prevalence of child abuse/neglect history was high among MMTP drop-outs: sexual abuse-36%; physical abuse-60%; emotional abuse-57%; child physical neglect-66%; all four experiences-25%. As assessed via ASI composite scores, those who had been abused in childhood had significantly more medical, legal, relationship, and psychological problems than those who had not. Overall, several significant associations were found between the abuse experiences and HIV risk behaviors. Those who had experienced child neglect were more likely to be HIV positive. In multivariate analyses, childhood physical abuse was a significant predictor of having multiple sex partners while depression was significantly related to injection drug use in adulthood (p<.05). There were trends for the relationships between childhood sexual abuse and HIV sex risk behavior (p<.10) and between gender and injection drug use (p<.10). CONCLUSIONS: The findings support a need for drug treatment programs that include specialized therapies for those who suffered childhood abuse and neglect experiences.