Adult sexual risk behavior in a Canadian sample of two-spirit, trans, and non-binary survivors of childhood sexual abuse.

BACKGROUND

Research on the impacts of CSA on survivors' sexual outcomes as adults has found an increase in sexual risk behaviors, including earlier sexual debut, greater involvement in transactional sex, and having sex under the influence of alcohol/drugs, among others. However, the impact of CSA on adult sexual risk behaviors in two-spirit, trans, and non-binary (2STNB) individuals has not been investigated.

OBJECTIVE

The goal of this investigation was to determine the impact of CSA on sexual risk as measured through a composite instrument in a sample of Canadian 2STNB adults and to identify contributors to this relationship.

PARTICIPANTS AND

SETTING

A sample of 309 Canadian 2STNB individuals was recruited through the assistance of community organizations; 125 identified having experienced CSA.

METHODS

Participants completed an online survey including measures of adverse childhood experiences, sexual self-esteem (SSE), condom self-efficacy (CSE), symptoms of post-traumatic stress disorder (PTSD), experiences of interpersonal violence (IPV), and sexual risk behavior, as well as demographic questions.

RESULTS

Path analysis demonstrated significant indirect effects from CSA to risk behavior through IPV and PTSD (β=.03, p<.05), and through IPV and CSE (β = -0.02, p < .05). The full sequential pathway from CSA through SSE and CSE to risk was not statistically significant (β = .04, p = .13), though significant pathways were observed between SSE and sexual risk (β=.38, p<.05), and from SSE to CSE to risk (β = .04, p < .05).

CONCLUSIONS

Experiences of CSA were associated with greater risk behavior in survivors through their experiences of IPV and PTSD symptoms. Focused attention on these mediators through education and therapy could help decrease risk behavior in survivors.