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The aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden. [ABSTRACT FROM AUTHOR]

Objectives: To determine the impact of child sexual abuse (CSA) on adult sexual behaviors and outcomes over three age periods. Methods: A longitudinal study of a birth cohort born in Dunedin, New Zealand in 1972/1973 was used. Information on CSA was sought at age 26, and on sexual behaviors and outcomes at ages 21, 26, and 32. Comparisons were over the whole period from age 18 to 32, then for the three age periods from age 18 to 21, 21 to 26, and 26 to 32, adjusting for measures of family environment. Results: Overall, 465 women and 471 men (91.9% of the surviving cohort) answered questions about CSA. Contact CSA was reported by 30.3% of women and 9.1% of men. For abused women, significantly increased rates were observed for number of sexual partners, unhappy pregnancies, abortion, and sexually transmitted infections from age 18 to 21; with rates approaching those of nonabused over time. Conversely, for abused men rates were not significantly elevated in the youngest age period, but were for number of partners from age 26 to 32 and acquisition of herpes simplex virus type 2 from age 21 to 32. Conclusions: Gender and age are critical when considering the effect of CSA. While the profound early impact of CSA demonstrated for women appears to lessen with age, abused men appear to carry increased risks into adulthood. Practice implications: CSA is common and should be considered when young women present with unwanted conceptions or seek multiple terminations, and when men continue to have high risk sexual behavior into adulthood. Furthermore, if CSA is disclosed, sexual risks in adulthood need to be considered. (Contains 1 figure and 5 tables.)

Objective: To study whether behavioral and emotional problems during childhood predicted early sexual debut, risky sex at age 21 years, and sexually transmitted infections up to age 21 years. Some possible mediational pathways were also explored. Method: Participants were enrolled in the Dunedin Multidisciplinary Health and Development Study (n = 1,037), a prospective, longitudinal study of a New Zealand birth cohort born in 1972-1973. Data obtained at ages 5, 7, 9, 11, 13, 15, and 21 years were used. Adjustment was made for gender, socioeconomic status, parenting factors, and residence changes. Results: High levels of antisocial behavior between age 5 and 11 years were associated with increased odds of early sexual debut (adjusted odds ratio [AOR] 2.17, 95% confidence [CI] 1.34-3.54) and risky sex (AOR 1.88, 95% CI 1.04-3.40). No relationship was observed between hyperactivity and later sexual health outcomes. In contrast, high levels of anxiety were associated with reduced odds of risky sex (AOR 0.45, 95%CI 0.25-0.80) and sexually transmitted infections (AOR 0.34, 95% CI0.17-0.70). Involvement with delinquent peers explained some of the association between antisocial behavior and early sexual debut and risky sex. A poor relationship with parents also explained some of the association between antisocial behavior and early sexual debut. Conclusions: The findings demonstrate links between behavioral and emotional problems occurring early in life and later deleterious sexual health outcomes. Targeting antisocial behavior and teaching accurate appraisals of danger during childhood may help mitigate these negative consequences.