Sexual Assault and Sexual Risk Behaviors Among Lower-Income Rural Women: The Mediating Role of Self-Worth.

Sexual victimization is associated with risky sexual behaviors. Limited research has examined mechanisms via which victimization affects risk behaviors, particularly following different types of sexual victimization. This study examined self-worth as a mediator of the relationship between sexual victimization history: contact childhood sexual abuse (CSA), completed rape in adolescence/adulthood (adolescent/adulthood sexual assault [ASA]), and combined CSA/ASA, and two sexual risk behaviors: past year partners and one-time encounters. Participants were diverse (57.9% African American), low-income women recruited from an OB-GYN waiting room (n = 646). Women with a history of sexual victimization, 29.8% (n = 186) reported lower self-worth, t(586) = 5.26, p < .001, and more partners, t(612) = 2.45, p < .01, than nonvictims. Self-worth was a significant mediator only among women with combined CSA/ASA histories in both risk behavior models.