Mediators of the Relation Between Childhood Sexual Abuse and Women’s Sexual Risk Behavior: A Comparison of Two Theoretical Frameworks

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood, but little research has investigated processes
that might mediate this relation. The purpose of this study was to investigate whether constructs suggested by the traumagenic
dynamics (TD) model (a theory of the effects of CSA) or constructs suggested by the information–motivation–behavioral skills
(IMB) model (a theory of the antecedents of sexual risk behavior) better mediated the relation between CSA and sexual risk
behavior in adulthood. Participants were 481 women attending a sexually transmitted infection clinic (66% African American)
who completed a computerized survey as well as behavioral simulations assessing condom application and sexual assertiveness
skills. Forty-five percent of the sample met criteria for CSA and CSA was associated with sexual risk behavior in adulthood.
In multiple mediator models, the TD constructs mediated the relation between CSA and the number of sexual partners whereas
the IMB constructs mediated the relation between CSA and unprotected sex. In addition, the TD constructs better mediated the
relation between CSA and the number of sexual partners; the TD and IMB constructs did not differ in their ability to mediate
the relation between CSA and unprotected sex. Sexual risk reduction interventions for women who were sexually abused should
target not only the constructs from health behavior models (e.g., motivation and skills to reduce sexual risk), but also constructs
that are specific to sexual abuse (e.g., traumatic sexualization and guilt).