Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim

Dube, Shanta R.; Anda, Robert F.; Whitfield, Charles L.; Brown, David W.; Felitti, Vincent J.; Dong, Maxia; Giles, Wayne H.

doi:10.1016/j.amepre.2005.01.015

« Previous Next »American Journal of Preventive Medicine
Volume 28, Issue 5 , Pages 430-438, June 2005

Long-Term Consequences of Childhood Sexual Abuse by Gender of Victim

Shanta R. Dube, MPH
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- Address correspondence and reprint requests to: Shanta R. Dube, MPH, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-67, Atlanta GA 30341-3724
Robert F. Anda, MD, MS
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Charles L. Whitfield, MD
- Private Practice in Addiction and Trauma Medicine, Atlanta, Georgia
David W. Brown, MSPH, MS
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Vincent J. Felitti, MD
- Department of Preventive Medicine, Southern California Permanente Medical Group, San Diego, California
Maxia Dong, MD, PhD
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Wayne H. Giles, MD, MS
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Background

Childhood sexual abuse (CSA) is a worldwide problem. Although most studies on the long-term consequences of CSA have focused on women, sexual abuse of both boys and girls is common. Thus, a comparison of the long-term effects of CSA by gender of the victim will provide perspective on the need for future research, prevention activities, and treatment of survivors.

Methods

A retrospective cohort study was conducted from 1995 to 1997 among 17,337 adult HMO members in San Diego, California. Participants completed a survey about abuse or household dysfunction during childhood, and multiple other health-related issues. Multivariate logistic regression was used to examine the relationships between severity of CSA (intercourse vs no intercourse) and long-term health and social problems (substance use and abuse, mental illness, and current problems with marriage and family) by gender of victim. Models controlled for exposure to other forms of adverse childhood experiences that co-occur with CSA. Among men, the relationship between the gender of the CSA perpetrator to the outcomes was also examined.

Results

Contact CSA was reported by 16% of males and 25% of females. Men reported female perpetration of CSA nearly 40% of the time, and women reported female perpetration of CSA 6% of the time. CSA significantly increased the risk of the outcomes. The magnitude of the increase was similar for men and women. For example, compared to reporting no sexual abuse, a history of suicide attempt was more than twice as likely among both men and women who experienced CSA (p<0.05). Compared with those who did not report CSA, men and women exposed to CSA were at a 40% increased risk of marrying an alcoholic, and a 40% to 50% increased risk of reporting current problems with their marriage (p<0.05).

Conclusions

In this cohort of adult HMO members, experiencing CSA was common among both men and women. The long-term impact of CSA on multiple health and social problems was similar for both men and women. These findings strongly indicate that boys and girls are vulnerable to this form of childhood maltreatment; the similarity in the likelihood for multiple behavioral, mental, and social outcomes among men and women suggests the need to identify and treat all adults affected by CSA.