Adverse childhood experiences, sexual risk-taking and non-consensual sexual experiences in a nationally representative study of 15-29-year-old Danes

Background: Adverse childhood experiences (ACEs) have been linked with risky health -related behaviors and poor health. Objective: This study aimed to investigate associations of ACEs with a broad panel of sexual risktaking behaviors and non-consensual sexual experiences among young people in Denmark. Participants and setting: Baseline questionnaire data from 15 to 29 -year -old participants in the nationally representative cohort study Project SEXUS were used in combination with data from Danish national registers to include a total of 13,132 individuals. Methods: In logistic regression analyses, confounder -adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were obtained for associations of five ACE categories (Household challenges, Loss or threat of loss, Material deprivation, Abuse, and Neglect) and a cumulative ACE score with measures of sexual risk -taking and non-consensual sexual experiences. Results: Statistically significant associations were observed between ACEs and multiple sexual risk -taking behaviors and non-consensual sexual experiences with particularly increased odds among individuals with a history of Abuse, Neglect, or an ACE score of 3 or more. Specifically, Abuse was associated with having received payment for sex (women: aOR 5.38; 95 % CI 2.73-10.61; men: aOR 2.11; 95 % CI 1.22-3.64), with having paid for sex (men: aOR 1.88; 95 % CI 1.41-2.51), and with having been the victim of a sexual assault after age 18 years (women: aOR 3.33; 95 % CI 2.36-4.68). Conclusions: In this Danish study, multiple measures of sexual risk -taking and non-consensual sexual experiences were markedly more common among young people with ACEs than in those without ACEs. This knowledge should be considered in future initiatives to promote sexual health among young people.