Sexual risk behavior in adolescence can result in serious health consequences that persist across the lifespan, particularly for female youth. While adverse childhood experiences (ACEs) are linked to engagement in sexual risk behavior later in life, little research has examined pathways that may help explain this association. To address this gap, the present study examined whether internalizing and externalizing behaviors mediated the link between (ACEs) and sexual risk behavior in female youth. We examined data from 122 adolescent girls, ages 13–18, who were involved in the juvenile justice system or receiving social supports from local agencies and schools. Girls were asked to report their exposure to ACEs and engagement in sexual risk behavior and caregivers were asked to report on girls’ internalizing and externalizing behaviors. Regression analyses indicated that girls who experienced more ACEs and exhibited more externalizing behaviors demonstrated higher rates of sexual risk. Further, externalizing behaviors partially mediated the association between ACEs and sexual risk behavior. Findings suggest that increased exposure to ACEs and higher incidence of externalizing behaviors may place girls at heightened risk for sexual risk behavior. Interventions aimed at decreasing externalizing behaviors may be particularly important in reducing sexual risk behavior among at-risk female youth.
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In our preliminary analysis, tolerance and VIF statistics were examined, falling within acceptable limits, with tolerance statistics ranging from .54 to .97 and VIF statistics ranging from 1.04 to 1.86. Therefore, we determined that collinearity was not a problem in the current model.
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Support for this research was provided by P50 DA035763 from the Division of Epidemiology, Services, and Prevention Research, NIDA U.S. PHS. The authors wish to thank the girls and caregivers who participated in this study, Sally Guyer for her data management assistance, and Patricia Chamberlain and Rohanna Buchanan for their roles in the development of the intervention for this study.
Disclosure of Interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Ethical Standards and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.
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Kovensky, R., Anderson, D. & Leve, L.D. Early Adversity and Sexual Risk in Adolescence: Externalizing Behaviors as a Mediator. Journ Child Adol Trauma 13, 173–184 (2020). https://doi.org/10.1007/s40653-019-00278-w
- Adverse childhood experiences
- Sexual risk
- Internalizing behavior
- Externalizing behavior