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Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women

Author

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  • Jordan L. Thomas

    (Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA)

  • Jessica B. Lewis

    (Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA)

  • Jeannette R. Ickovics

    (Yale-NUS College, Singapore 138527, Singapore
    Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA)

  • Shayna D. Cunningham

    (Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06032, USA)

Abstract

Epidemiological evidence suggests that exposure to adverse childhood experiences (ACEs) is associated with sexual risk, especially during adolescence, and with maternal and child health outcomes for women of reproductive age. However, no work has examined how ACE exposure relates to sexual risk for women during the postpartum period. In a convenience sample of 460 postpartum women, we used linear and logistic regression to investigate associations between ACE exposure (measured using the Adverse Childhood Experiences Scale) and five sexual risk outcomes of importance to maternal health: contraceptive use, efficacy of contraceptive method elected, condom use, rapid repeat pregnancy, and incidence of sexually transmitted infections (STIs). On average, women in the sample were 25.55 years of age (standard deviation = 5.56); most identified as Black (60.4%), White (18%), or Latina (14.8%). Approximately 40% were exposed to adversity prior to age 18, with the modal number of experiences among those exposed as 1. Women exposed to ACEs were significantly less likely to use contraception; more likely to elect less-efficacious contraceptive methods; and used condoms less frequently ( p = 0.041 to 0.008). ACE exposure was not associated with rapid repeat pregnancy or STI acquisition, p > 0.10. Screening for ACEs during pregnancy may be informative to target interventions to reduce risky sexual behavior during the postpartum period.

Suggested Citation

  • Jordan L. Thomas & Jessica B. Lewis & Jeannette R. Ickovics & Shayna D. Cunningham, 2021. "Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women," IJERPH, MDPI, vol. 18(7), pages 1-10, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:7:p:3848-:d:531180
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    References listed on IDEAS

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    1. Ickovics, J.R. & Earnshaw, V. & Lewis, J.B. & Kershaw, T.S. & Magriples, U. & Stasko, E. & Rising, S.S. & Cassells, A. & Cunningham, S. & Bernstein, P. & Tobin, J.N., 2016. "Cluster randomized controlled trial of group prenatal care: Perinatal outcomes among adolescents in New York city health centers," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 359-365.
    2. Kershaw, T.S. & Magriples, U. & Westdahl, C. & Rising, S.S. & Ickovics, J., 2009. "Pregnancy as a window of opportunity for HIV prevention: Effects of an HIV intervention delivered within prenatal care," American Journal of Public Health, American Public Health Association, vol. 99(11), pages 2079-2086.
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    Cited by:

    1. Sara K. Wood & Kat Ford & Hannah C. E. Madden & Catherine A. Sharp & Karen E. Hughes & Mark A. Bellis, 2022. "Adverse Childhood Experiences and Their Relationship with Poor Sexual Health Outcomes: Results from Four Cross-Sectional Surveys," IJERPH, MDPI, vol. 19(14), pages 1-13, July.

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