Dispelling stigmatizing misconceptions: A cross-sectional analysis of the impact of the adverse childhood experience of forced sexual intercourse on high-risk sexual behavior and weight status among adolescent girls

Abstract

AbstractAlthough early sexual initiation (ESI) and elevated body mass index (BMI) are widely considered a threat to positive health, the misconception that elevated BMI is predictive of ESI produces additional stigmatizing burden for overweight or obese adolescent girls. This study expands on prior findings by exploring mediating impact of the adverse childhood experience (ACE) of forced sexual intercourse on BMI and ESI. Data from the U.S. population-based 2019 National Youth Risk Behavior Surveillance System (YRBS) were analyzed using complex samples analytic methods. Girls who reported forced intercourse experience and were Black or African American were more likely to report ESI, while those who were overweight or obese were no more likely to have engaged in ESI than healthy weight girls, when controlling for other ESI related risk-factors. Among girls who never experienced forced intercourse, current and prior substance use were predictive of ESI. Findings indicate that weight status does not impact ESI when accounting for forced sexual experiences, while early exposure to substance use may be a leverage point for intervention to reduce ESI among girls with prior experience of force. When developing interventions designed to reduce ESI, it is important to understand and account for the impact of ACEs.