Background

Adverse childhood experiences (ACEs) are a prevalent concern linked to poor health outcomes, including in the area of sexual health.

Objective

The current study explored factors that might impact sexual health attitudes and behaviors among college students exposed to ACEs. We examined: a) regulatory focus (i.e., type of goals that individuals are likely to pursue), and b) patient activation (i.e., degree of skills, knowledge, beliefs, and motivations that a person has related to their health).

Participants and setting

College students (N = 503) completed an online survey.

Methods

The survey assessed exposure to ACEs, regulatory focus, patient activation, condom use self-efficacy, condom embarrassment, and number of past year sexual partners.

Results

Reporting a higher number of ACEs was related to greater prevention regulatory focus (p < .001) and lower patient activation (p < .01). In a path analysis examining the indirect effect of ACEs on sexual health through prevention regulatory focus, higher ACEs predicted greater prevention focus which, in turn, predicted fewer sexual partners (β = −0.02, p = .041) and higher condom use self-efficacy (β = 0.03, p = .024). In a path analysis examining the impact of ACEs on sexual health through patient activation, ACEs predicted lower patient activation which, in turn, predicted lower condom use self-efficacy (β = −0.02, p = .048) and higher condom embarrassment (β = 0.02, p = .042).

Conclusions

Prevention-focused health messages and improving patient activation may be useful components of interventions targeting sexual health among young adults exposed to ACEs.

中文翻译：

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年轻人的不良童年经历和性健康：检查监管重点和患者激活的作用

背景

不良童年经历 (ACE) 是与不良健康结果相关的普遍问题，包括在性健康领域。

客观的

目前的研究探讨了可能影响暴露于 ACE 的大学生的性健康态度和行为的因素。我们检查了：a) 监管重点（即个人可能追求的目标类型），以及 b) 患者的积极性（即一个人与其健康相关的技能、知识、信念和动机的程度）。

参与者和设置

大学生 (N = 503) 完成了在线调查。

方法

该调查评估了 ACE 的暴露情况、监管重点、患者活跃度、安全套使用自我效能、安全套尴尬和过去一年的性伴侣数量。

结果

报告较高数量的 ACE 与更大的预防监管重点 ( p  < .001) 和较低的患者激活 ( p  < .01) 相关。在通过预防监管重点检查 ACE 对性健康的间接影响的路径分析中，较高的 ACE 预测了更多的预防重点，这反过来又预测了更少的性伴侣（β = -0.02，p  = .041）和更高的安全套使用自我功效（β = 0.03，p  = .024）。在通过患者激活检查 ACE 对性健康影响的路径分析中，ACE 预测较低的患者激活，进而预测较低的安全套使用自我效能（β = -0.02，p  = .048）和较高的安全套尴尬（β = 0.02，p  = .042）。

结论

以预防为重点的健康信息和改善患者的积极性可能是针对暴露于 ACE 的年轻人的性健康的干预措施的有用组成部分。