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Exposure to Violence and Associated Health-Risk Behaviors Among Adolescent Girls
Abbey B. Berenson, MD;
Constance M. Wiemann, PhD;
Sharon McCombs, MHSM
Arch Pediatr Adolesc Med. 2001;155:1238-1242.
Objective To examine the relationship between exposure to violence and health-risk
behaviors.
Design Cross-sectional survey.
Setting University-based outpatient family planning clinic.
Patients Sexually active adolescent girls younger than 18 years (N = 517) who
presented for contraceptive care.
Main Outcome Measures Prevalence of witnessing or experiencing violence and the associations
with health-risk behaviors, including high-risk sexual behaviors, substance
use, and self-injury.
Results Compared with adolescents who had not been exposed to violence, those
who had only witnessed violence were 2 to 3 times more likely to report using
tobacco and marijuana, drinking alcohol or using drugs before sex, and having
intercourse with a partner who had multiple partners. Those who had experienced,
but not witnessed violence were at increased risk of these same behaviors
and were 2 to 4 times more likely than those who had neither witnessed nor
experienced violence to report early initiation of intercourse, intercourse
with strangers, multiple partners, or partners with multiple partners, tobacco,
alcohol and drug use, or to have positive test results for a sexually transmitted
disease. Individuals who had both witnessed and experienced violence demonstrated
the greatest risk of adverse health behaviors. These adolescents demonstrated
3 to 6 times greater risk of suicidal ideation (odds ratio [OR], 3.1; 95%
confidence interval [CI], 2.2-4.0) or suicide attempts (OR, 4.5; 95% CI, 2.2-9.4),
self-injury (OR, 5.8; 95% CI, 2.6-12.9), and use of drugs before intercourse
(OR, 6.2; 95% CI, 3.0-12.9) than those who had neither witnessed nor experienced
violence.
Conclusions Adolescents exposed to violence are at increased risk of multiple adverse
health behaviors. Programs designed to improve health outcomes should target
this high-risk group.
From the Divison of Pediatric and Adolescent Gynecology, Department
of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston.
Corresponding author and reprints: Abbey B. Berenson, MD, Division
of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology,
The University of Texas Medical Branch at Galveston, 301 University Blvd,
Galveston, TX 77555-0587 (e-mail: abberens{at}utmb.edu).
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