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On a routine and daily basis, women are exposed to sexually objectifying experiences, which result in a number of harmful psychosocial outcomes (Fredrickson & Roberts, 1997). Five-hundred and forty-sex women attending a large, Southeastern university participated in this study that investigated a conceptual model of how childhood sexual abuse (CSA) contributes to sexual risk behaviors (SRBs) via self-objectification (S0). In order to assess the causal relationships among variables, measured variable path analyses were conducted in order to test two theoretical models. The following instruments were used in this investigation: the Sexual Abuse Subscale of the Childhood Trauma Questionnaire (a measure assessing experiences of childhood sexual abuse [Bernstein, Stein, Newcomb, Walker, Pogge, Ahluvia et al., 2003]); the Body Surveillance Subscale of the Objectified Body Consciousness Scale (a measure assessing self-objectification [McKinley & Hyde, 1996]); the Body Shame Subscale of the Objectified Body Consciousness Scale (a measure assessing body shame [McKinley & Hyde, 1996]); the Toronto Alexithymia Scale-20 (assesses alexithymic symptoms, or difficulty identifying, describing, and expressing one’s emotions [Bagby, Parker, & Taylor, 1994]), the Contraceptive Self-Efficacy Scale (assesses overall sexual self-efficacy, such as the ability to insist upon sexual protection [Levinson, 1986]), and the Sexual Risk Survey (assesses risky sexual practices [Turkchik & Garske, 2009]). Results revealed that the data fit the second model better than the first. Specifically, data revealed that CSA directly predicted SRBs and was not mediated via SO, but was partially mediated by alexithymia and body shame. That is, CSA predicted increased alexithymia and body shame. Increased alexithymia predicted SRBs, whereas body shame decreased SRBs. Results also revealed that alexithymia and body shame mediated the relationship between SO and SRBs. Specifically, self-objectification led to increased alexithymia and body shame, and alexithymia increased SRBs while body shame decreased SRBs. Last, results revealed that body shame fully mediated the relationship between both CSA and SO and sexual self-efficacy. Pathways were significant at the p < .05 level.

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.

Childhood sexual abuse (CSA) is one of the least studied HIV-related risk factors in Haiti although research in the United States and Europe has clearly established the link between childhood trauma and HIV risk behaviors. Understanding the role and impact of CSA on HIV-positive Haitian women is likely to strengthen future HIV prevention and treatment efforts aimed at this vulnerable group. The current study was a cross-sectional examination of baseline data collected during a randomized trial of a cognitive-behavioral stress management (CBSM) intervention in Haiti. The purpose of this study was to analyze the association between CSA and sexual risk behaviors, alcohol use, and social support in a group of Haitian women, ages 17-55 (n=229), who are HIV-positive alcohol users living in Haiti. The outcomes investigated were the respondents’ level of exposure to CSA and their current HIV-related risk factors. The Theory of Gender and Power provided the theoretical framework for variable selection and associative exploration. Statistical tests included descriptive analyses, chi-square tests, analysis of variance (ANOVA), and correlations. Results showed that women who were exposed to some level of sexual abuse during childhood had less favorable attitudes towards condom use than women who reported no exposure to sexual abuse during childhood [F(2, 217) = 5.10, p = .007]. There were no differences between exposure groups for the remaining sexual risk behaviors: multiple partners, knowledge of HIV, and sexual self-efficacy. Women who were exposed to CSA also reported higher levels of alcohol use than reported by the women in the non-exposure group. Finally, there were no differences between exposure groups for social support. Group differences in attitudes towards condom use and levels of alcohol use among HIV-positive Haitian women demonstrate that HIV-positive individuals have different past and present experiences that affect their current beliefs and behaviors. Examining women at the beginning of their diagnosis for childhood trauma and providing targeted interventions for coping with that trauma presents a valuable research opportunity. The findings of the current study suggest that more research is required to understand the association between CSA and HIV-related risk factors in this subset of the HIV-positive population.

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