Our hypothesis that SA women would report greater likelihood of risky sexual behavior was partially supported. CSA women reported less likelihood of condom use with their partner in the vignette than did NSA and ASA women, but also reported less likelihood of intercourse. ASA and NSA women did not differ in regards to sexual risk likelihood. We also found support for the hypothesis that alcohol would increase the likelihood of risky sexual behavior: Intoxicated women reported less likelihood of condom use and greater likelihood of oral sex and unprotected intercourse than did sober women. Also as hypothesized, intoxicated women reported greater sexual arousal than did sober women. We did not find support for our hypothesis that abuse history and alcohol intoxication would interact to increase sexual risk-taking. Also, in contrast to past reports, we found no differences in genital arousal based on abuse history (Laan & Everaerd, 1995
; Rellini & Meston, 2006
; Schacht et al., 2007
The finding that CSA women reported less likelihood of condom use relative to NSA women was consistent with other evidence that CSA women are less likely to use condoms than are non-abused women (Greenberg et al., 1999
) and have higher rates of STIs than do non-CSA women (Arriola, Louden, Doldren, & Fortenberry, 2005
; Koenig & Clark, 2003
). Partner communication and women’s perception of their partners’ attitudes towards condoms are the strongest psychosocial predictors of condom use (Sheeran et al., 1999
), and CSA women are less confident about refusing unprotected sex than are non-abused women (Hamburger et al., 2004
; Greenberg et al., 1999
). This finding may suggest that CSA women’s increased sexual risk is driven in part by condom negotiation reticence. It is also possible that CSA women reported less likelihood of condom use than did NSA and ASA women because they were less interested in intercourse with their partner in the vignette. However, we found no difference based on abuse history for another risky behavior–likelihood of genital contact–which implies that CSA women may be as likely as ASA and NSA women to engage in some STI risk behaviors without condoms.
We replicated findings indicating that alcohol intoxication increases sexual risk behavior (Davis, Hendershot, George, Norris, & Heiman, 2007
; MacDonald, MacDonald, Zanna, & Fong, 2000
; Maisto, Carey, Carey, & Gordon, 2002
; Maisto, Carey, Carey, Gordon, & Schum, 2004
). Also congruent with past work (e.g., George et al., in press
) was the finding that alcohol intoxication increased self-reported, but not genital, sexual arousal. Condom negotiation while under the influence of alcohol, including psychoeducation regarding alcohol’s deleterious influence on condom negotiation, may be worthy targets for sexual risk prevention programs. Null findings regarding the interaction between abuse history and alcohol intoxication on sexual risk behavior may have been due to lack of power. However, it is also possible that the influence of alcohol intoxication and SA history have opposite effects (i.e., one may disinhibit whereas the other inhibits), thereby cancelling each other out.
CSA and ASA have both been linked to subsequent psychopathology (e.g., Briere & Jordan, 2004
; Finkelhor & Browne, 1988
; Paolucci & Genuis, & Violato, 2001
; Trickett & Putnam, 1993
), but same-sample comparisons of individuals reporting histories of CSA and ASA are rare. Therefore, the extent to which CSA and ASA have overlapping sequelae is unclear. We found that CSA women differed from NSA and ASA women on some variables, but found no differences between ASA and NSA women. Our CSA sample was small, but these findings are consistent with the notion that the timing of abuse is an important consideration when predicting subsequent behavior changes. Noll, Trickett, and Putnam (2003)
described behavior patterns of “sexual preoccupation” (e.g., increased sexual activity and partners) and “sexual aversion” (e.g., increased rates of sexual dysfunction) in CSA women, an idea proposed by Finkelhor and Brown (1988)
. The finding that CSA women reported less likelihood of intercourse relative to NSA and ASA women could be interpreted to indicate sexual aversion, although other interpretations are possible (e.g., social desirability). Furthermore, it is possible that situational factors (e.g., alcohol intoxication or the sexual activity in question) can affect whether sexually preoccupied or sexually aversive behavior is elicited from CSA women.
Limitations, Strengths, and Future Directions
Conclusions regarding these results should be made cautiously due to sampling issues. Our sample was small; thus, these findings may be limited in generalizability. In addition, our null finding for VPA differences, which contradicts past findings with CSA women (Laan & Everaerd, 1995
; Rellini & Meston, 2006
; Schacht et al., 2007
), may be due to lack of power because of sample size or to a weaker VPA response to textual (the vignette) relative to visual (films) erotic stimuli. Future work should re-evaluate the possibility that abuse history and alcohol intoxication interact to influence sexual risk behavior. Other issues that may limit generalizability of results are volunteer and sampling biases. As is typical of participants willing to participate in studies using genital measures of sexual response (Strassberg & Lowe, 1995
), our sample appeared to be more sexually experienced than other U.S. women in their age group, reporting a median of nine lifetime heterosexual partners. In a recent national survey, women aged 25 to 29 years reported a median of four lifetime heterosexual partners (including vaginal, oral, and anal sex; CDC, 2005b
). In addition, we recruited only single women who reported that they were social, non-problem drinkers. The extent to which the women in our sample, particularly CSA-only women, were representative of larger samples, is unknown. In addition, the vignette paradigm used in this study may be limited in its external validity.
We did not evaluate partner interactions and condom negotiation, which influence in-the-moment decisions regarding condom use, nor did we evaluate alcohol’s expectancy effects, which could account in part for our findings. Our work may be oversimplified relative to real-life situations, but represents an initial snapshot of SA women’s responses to a sexual risk situation, which can provide a starting point for more complex evaluations of these processes. More work is needed to understand the partner interactions relevant to condom use.
These findings are important because of the lack of published reports comparing CSA-only and ASA-only women on any outcome variables. These findings also speak to the extensive literature linking alcohol consumption, sexual assault, and HIV/STI risk (e.g., Abbey, Zawacki, Buck, Clinton, & McAuslan, 2001; Senn, Carey, Vanable, Coury-Doniger, & Urban, 2006
).We found differences in likelihood of risky sex between abuse groups, which may indicate that CSA-only women’s experience and behavior in sexual situations diverges from that of other SA women’s experiences. Further research in this area with a larger, more varied sample is warranted.