Young women victimized in adolescence are at risk of further sexual violence.

Thirty percent of 14-23-year-old females who sought services at an adolescent health center in New York City between October 2000 and February 2002 reported an unwanted sexual experience in the past 12 months. (1) Of the participants in this urban study, 13% reported rape or attempted rape, 10% verbal sexual coercion and 6% unwanted touching. Risk factors associated with such experiences included past sexual victimization as an adolescent, past physical or verbal aggression from partners, going to perpetrators' homes to be alone with them and a lower level of romantic involvement in the most recent relationship. Females who went on a higher number of dates with their partners, those who were pressured to drink alcohol and those who refused to drink on a date were at increased risk of verbal sexual coercion; this risk also increased with a greater age difference between partners.

This cross-sectional study surveyed a population of 689 ethnically diverse women: Forty-two percent were black, 31% Puerto Rican, 17% Dominican and 10% white. To be eligible for the study, females had to be 14-23 years old, not married or living with a partner, and not pregnant, and had to have been on at least one date in the past year. Forty-six percent had had two or fewer lifetime partners, 29% had had 3-5 and 25% had had six or more.

Participants completed questionnaires on demographic and reproductive attributes, dating history and involvement, and substance use by themselves and their partners. The Sexual Experiences Survey, a commonly used instrument, measured sexual violence and unwanted sexual experiences in the past 12 months and over participants' lifetimes; women were classified as having experienced no victimization, unwanted sexual contact (touching or kissing without permission), rape or attempted rape (using force, alcohol, drugs or position of power), or verbal sexual coercion (being talked or pressured into unwanted sexual intercourse). A second standard instrument, the Dating Violence Questionnaire, measured the amount of verbal and physical abuse that participants had experienced. Logistic regression analysis was used to identify correlates of rape or attempted rape and verbal sexual coercion. Only 6% of females reported unwanted touching; because of the low number this proportion represents, the authors conducted no analysis of this subgroup.

Thirteen percent of all participants reported rape or attempted rape in the preceding 12 months, and this risk was associated with a number of characteristics of their sexual history and behavior. Compared with women who reported no unwanted sexual experiences, those who had experienced mild to moderate physical aggression or severe aggression by a dating partner had an elevated likelihood of reporting rape or attempted rape (odds ratios, 4.3 and 15.2, respectively). Past sexual victimization as an adolescent was also associated with rape or attempted rape (4.7), as was visiting the perpetrator's home to be alone with him (3.0). The higher the woman rated her romantic involvement with the partner (using a 10-point scale), the lower her odds of rape or attempted rape (0.6 per point). The lower the participant rated the importance of her ethnic identity, the higher her odds of reporting such an experience (1.1 per point).

Ten percent of study participants reported verbal sexual coercion in the previous year. Women who had experienced mild to moderate verbal aggression or severe verbal aggression had higher odds of reporting such coercion than those who had experienced no such aggression (odds ratios, 4.4 and 13.8, respectively). Women were also at increased risk if they had previously been sexually victimized as adolescents (9.8) or had visited their partner's home to be alone with him (3.5); their risk declined as their reported level of romantic involvement increased (0.7 per point). Furthermore, participants who had gone on six or more dates with their partner had an elevated likelihood of reporting verbal coercion (7.5), and the greater the age difference between partners, the higher the woman's risk (1.2 per year difference).

In addition, compared with women who did not report unwanted experiences, women reporting verbal sexual coercion had increased odds of having been pressured by their partners to use alcohol (odds ratio, 9.5), of having refused to drink alcohol during the date when the coercion occurred (14.4) and of having used marijuana in the past year (3.6).

The authors state that the main strength of their study was that it surveyed a racially and ethnically diverse sample of 14-23-year-old females. Yet the application of these findings to a broader population may be limited by its focus on urban females who actively sought care at a health clinic. Nonetheless, the study identifies several risk factors that are associated with an increased likelihood of rape, attempted rape and verbal sexual coercion, and highlights "the need to educate young women on how to effectively manage verbal and psychological abuse and other types of coercive behaviors that may be exerted by male partners."

REFERENCE

(1.) Rickert VI et al., Rates and risk factors for sexual violence among an ethnically diverse sample of adolescents, Archives of Pediatrics and Adolescent Medicine, 2004, 158(12):1132-1139.