Sexual Assault and Sexual Risk Behaviors Among Lower-Income Rural Women: The Mediating Role of Self-Worth

Sexual victimization is associated with risky sexual behaviors. Limited research has examined mechanisms via which victimization affects risk behaviors, particularly following different types of sexual victimization. This study examined self-worth as a mediator of the relationship between sexual victimization history: contact childhood sexual abuse (CSA), completed rape in adolescence/adulthood (adolescent/adulthood sexual assault [ASA]), and combined CSA/ASA, and two sexual risk behaviors: past year partners and one-time encounters. Participants were diverse (57.9% African American), low-income women recruited from an OB-GYN waiting room (n = 646). Women with a history of sexual victimization, 29.8% (n = 186) reported lower self-worth, t(586) = 5.26, p < .001, and more partners, t(612) = 2.45, p < .01, than nonvictims. Self-worth was a significant mediator only among women with combined CSA/ASA histories in both risk behavior models.