The Relationship between Childhood Sexual Abuse and Sexual Health Practices of Homeless Adolescents

Article excerpt

Many adolescents who experience childhood sexual abuse suffer short- and long-term negative outcomes such as depression, low self-esteem, substance abuse, inappropriate sexual behavior, poor social relationships, self-destructive behavior, and runaway behavior (Garnefski & Arends, 1998; Rew, Taylor-Seehafer, & Fitzgerald, 2001; Stewart, Steiman, Cauce, Cochran, Whitbeck, & Hoyt, 2004). Each year thousands of children run away from home to escape physical or sexual abuse or neglect, while others are forced out of their home by their parents (de Man, 2000; Rew, Fouladi, & Yockey, 2002. Unfortunately, many end up on the streets. Adolescents without permanent homes are sometimes classified as "runaways" if they have chosen to leave home, and "homeless" if they have been thrown out of their homes (Rotherman-Borus, Parra, Cantwell, Gwadz, & Murphy, 1996).

Researchers have reported that sexual abuse is one of the major factors that cause youth to leave home (Rew, Taylor-Seehafer, Thomas, & Yockey, 2001; Rotheram-Borus, Mahler, Koopman, & Langabeer, 1996; Whitbeck, Hoyt, & Ackley, 1997). Among homeless youth, more females than males have reported histories of childhood sexual abuse (Cauce et al., 2000). Since each individual is unique, the effects of sexual abuse are not exactly the same for everybody. Data from adolescents, in the Massachusetts Youth Risk Survey suggest that, although sexual abuse of girls may be more prevalent, the adverse effect of sexual abuse on risky behavior may be even greater for boys (Raj, Silverman, & Amaro, 2000). Although the majority of research indicates that there are more similarities than differences between male and female survivors of sexual abuse (Gold, Lucenko, Elhai, et al., 1999), there are, nevertheless, several differences that merit attention. This study explored the gender differences in sexual self-concept, personal resources for sexual health, safe sex behaviors and risky sexual behaviors among homeless adolescents with and without histories of sexual abuse. Following approval of the study, extant data from the comparison group of the original intervention study were analyzed to answer the following research questions:

1. What are the gender differences in the sexual self-concept of homeless adolescents who self-report a history of sexual abuse?

2. What are the differences in sexual self-concept between homeless adolescents who self-report a history of sexual abuse and those who do not?

3. What are the differences in personal resources for sexual health (knowledge of STDs, future time perspective, intention to use condoms, self-efficacy to use condoms, assertive communication, and self-efficacy to perform breast or testicular self-examination) between homeless adolescents who self-report a history of sexual abuse and those who do not?

4. What are the differences in safe sex behaviors and sexual self-care strategies between homeless adolescents who self-report a history of sexual abuse and those who do not?

5. What are the differences in risky sexual behaviors between homeless adolescents who self-report a history of sexual abuse and those who do not?

6. What are the gender differences in the sexual self-concept, personal resources for sexual health, safe sex and sexual self-care behaviors, and risky sex behaviors between homeless adolescents who self-report a history of sexual abuse and those who do not?

BACKGROUND

The prevalence of, and problems associated with, sexual abuse (SA) have not been sufficiently researched in the homeless adolescent population. Because of lack of data, gaps in the literature, and limited understanding of important relationships between childhood sexual abuse and health behaviors in the homeless population, it is imperative that public health care professionals, health care providers and individuals in all components of the community outreach system are informed about the prevalence and dynamics of sexual abuse, and victims' experiences among this underserved population. …