In this issue.(Brief Article)

Every year, thousands of American women and children suffer various forms of physical and sexual abuse, often perpetrated by family members or intimate partners. While this much is news to no one, the study of how such abuse affects women's sexual and reproductive health and behavior is a fairly recent addition to the research agenda. Two articles in this issue of Perspectives on Sexual and Reproductive Health tackle some of the many questions that warrant attention.

In the lead article [page 62], Pamela Jo Johnson and Wendy Hellerstedt examine the relationship between abuse and sexually transmitted diseases (STDs) among women. Previous studies have found a positive relationship between having a history of experiencing physical or sexual violence and having a self-reported STD history. Johnson and Hellerstedt, however, add two twists to this line of inquiry: Using data on a sample of prenatal clinic patients, they analyze how the odds not only of having a history of STD but also of having a current STD infection are affected by the experience of abuse. And they use medical documentation (a more reliable indicator than self-reports) to assess women's past and current STD status.

In this population of pregnant women of low socioeconomic status, those who had suffered any abuse had a significantly increased likelihood both of having a history of STD and of having a current infection. Their odds of either outcome were about twice those of nonabused women; the differential was even sharper--the odds were roughly tripled--for women who had suffered both physical and sexual abuse. Further research will be needed to determine the biological and behavioral risks that characterize the sexual environments of women who experience abuse.

Lynn Blinn-Pike and colleagues ask a very different question about abuse: whether it can be causally linked to adolescent pregnancy [page 68]. In a search of the literature in three relevant disciplines, they found 15 studies published between 1990 and 2000 that addressed the relationship between sexual maltreatment, alone or in combination with other types of maltreatment, and adolescent pregnancy. As Blinn-Pike and her coauthors note, results of the studies show little agreement: Ten studies supported a causal link, and five either did not support a link or qualified the relationship. In addition, the studies were weakened by methodological flaws and a lack of theoretical grounding, and comparisons across studies are difficult to make because they did not rely on consistent definitions of maltreatment. The bottom line, according to the authors of the review, is that the evidence is insufficient to conclusively establish or deny a causal relationship between abuse and teenage pregnancy.

Also in This Issue

* How do women view HIV testing, ...