Authors' Affiliations

1Elaine Loudermilk, MPH, 1Megan Quinn, DrPH, MSc, 1Liang Wang, MD, DrPH, MPH 1Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University

Location

AUDITORIUM ROOM 137B

Start Date

4-4-2018 1:40 PM

End Date

4-4-2018 1:55 PM

Name of Project's Faculty Sponsor

Liang Wang

Faculty Sponsor's Department

Department of Biostatistics and Epidemiology

Type

Oral Presentation

Classification of First Author

Graduate Student-Doctoral

Project's Category

Social and Behavioral Sciences

Abstract Text

Introduction: Adverse childhood experiences (ACEs) have been linked with negative physical and mental health outcomes in adulthood. A limited amount of literature has discussed the impact of individual ACEs on HIV risk behaviors using nationally representative data.

Objective: This study investigated how ACEs impact HIV risk behaviors using cross-sectional data from the 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS).

Methods: Data were obtained from BRFSS for 2011 and 2012. Only states that answered the optional ACE questionnaire were included in the study. All ten ACEs were categorized into abuse (parents physically hurt you in any way or parents swore, insulted or put you down), household dysfunction (lived with anyone mentally ill, lived with parental alcoholic, lived with parental drug abuser, had a parent incarcerated, parents beat each other, or parents were divorced or separated) and childhood sexual abuse (forced to have sex, forced to touch sexually, or forced to be touched sexually). The number of individuals in each category were then categorized based on if they said yes to HIV risk behaviors: used intravenous drugs in the past year, been treated for a sexually transmitted or venereal disease in the past year, and/or given or received anal sex without a condom in the past year. Sociodemographic factors were assessed including race (White, Black, Hispanic, or Other), sex, income (<$15,000, $15,000-<$25,000, $25,000-<$35,000, $35,000-<$50,000, and >$50,000), education (high school education or less and some college or more), age (18-34, 35-54, and 55+) and marital status (currently married or widowed and never married, divorced or separated). Weighted multiple logistic regression analyses were used to examine the association between ACEs and HIV risk behaviors controlling for sociodemographic characteristics.

Results: The unweighted sample size was 151,289. The final adjusted sample size was 58,622. Majority of those who said yes to HIV risk behaviors were among the ages of 18-34 (7.92%) compared to other age categories. Adults with an income of <$15,000 had a higher prevalence of saying yes to HIV risk behaviors compared to all other income categories (6.30% vs. 4.85% vs. 3.87% vs. 3.12% vs 2.33%). Adults who experienced growing up with a parent in jail or had a parent who abused drugs had a higher prevalence of saying yes to HIV risk behaviors (11.18% and 11.14% respectively). Of the 4.34% of adults who were forced to have sex as a child, 12.17% said yes to HIV risk behaviors. All ACEs were significantly associated with HIV risk behaviors (P<0.0001). Multiple logistic regression analysis show that adults who grew up with parents who abused drugs (Odds Ratio (OR)= 1.74, 95% Confidence Interval (CI)= 1.72-1.74) or were forced to have sex as a child (OR=1.70, 95% CI=1.68-1.72) were more likely to have HIV risk behaviors. Not being currently married or widowed increased the odds of HIV risk behaviors by 2.31 times (OR= 2.31, 95% CI= 2.30-2.33).

Conclusions: ACEs were positively associated with HIV risk behaviors. Longitudinal studies are warranted to confirm the causal relationship. Educational and prevention measures may be considered to address this public health problem.

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Apr 4th, 1:40 PM Apr 4th, 1:55 PM

Impact of Adverse Childhood Experiences on HIV Risk Behaviors using a Nationally Representative Sample from 2011 and 2012

AUDITORIUM ROOM 137B

Introduction: Adverse childhood experiences (ACEs) have been linked with negative physical and mental health outcomes in adulthood. A limited amount of literature has discussed the impact of individual ACEs on HIV risk behaviors using nationally representative data.

Objective: This study investigated how ACEs impact HIV risk behaviors using cross-sectional data from the 2011 and 2012 Behavioral Risk Factor Surveillance System (BRFSS).

Methods: Data were obtained from BRFSS for 2011 and 2012. Only states that answered the optional ACE questionnaire were included in the study. All ten ACEs were categorized into abuse (parents physically hurt you in any way or parents swore, insulted or put you down), household dysfunction (lived with anyone mentally ill, lived with parental alcoholic, lived with parental drug abuser, had a parent incarcerated, parents beat each other, or parents were divorced or separated) and childhood sexual abuse (forced to have sex, forced to touch sexually, or forced to be touched sexually). The number of individuals in each category were then categorized based on if they said yes to HIV risk behaviors: used intravenous drugs in the past year, been treated for a sexually transmitted or venereal disease in the past year, and/or given or received anal sex without a condom in the past year. Sociodemographic factors were assessed including race (White, Black, Hispanic, or Other), sex, income (<$15,000, $15,000-<$25,000, $25,000-<$35,000, $35,000-<$50,000, and >$50,000), education (high school education or less and some college or more), age (18-34, 35-54, and 55+) and marital status (currently married or widowed and never married, divorced or separated). Weighted multiple logistic regression analyses were used to examine the association between ACEs and HIV risk behaviors controlling for sociodemographic characteristics.

Results: The unweighted sample size was 151,289. The final adjusted sample size was 58,622. Majority of those who said yes to HIV risk behaviors were among the ages of 18-34 (7.92%) compared to other age categories. Adults with an income of <$15,000 had a higher prevalence of saying yes to HIV risk behaviors compared to all other income categories (6.30% vs. 4.85% vs. 3.87% vs. 3.12% vs 2.33%). Adults who experienced growing up with a parent in jail or had a parent who abused drugs had a higher prevalence of saying yes to HIV risk behaviors (11.18% and 11.14% respectively). Of the 4.34% of adults who were forced to have sex as a child, 12.17% said yes to HIV risk behaviors. All ACEs were significantly associated with HIV risk behaviors (P<0.0001). Multiple logistic regression analysis show that adults who grew up with parents who abused drugs (Odds Ratio (OR)= 1.74, 95% Confidence Interval (CI)= 1.72-1.74) or were forced to have sex as a child (OR=1.70, 95% CI=1.68-1.72) were more likely to have HIV risk behaviors. Not being currently married or widowed increased the odds of HIV risk behaviors by 2.31 times (OR= 2.31, 95% CI= 2.30-2.33).

Conclusions: ACEs were positively associated with HIV risk behaviors. Longitudinal studies are warranted to confirm the causal relationship. Educational and prevention measures may be considered to address this public health problem.