The Impact of Adverse Childhood Experiences on Sexual Well-being among Youth Formerly in the Foster Care System

Headnote

This study evaluates the impact of broad and singular measures of adverse childhood experiences (ACE) and severity of sexual abuse on sexual well-being among youth formerly in the foster care system (YFFC). Divorce, alcohol/ drug use within the home, the presence of mental illness or a family member suicide attempt, and sexual abuse severity increased odds of negative sexual outcomes and predicted lower sexual well-being. ACE levels negatively impacted outcomes but positively impacted sexual well-being. Research must move beyond summative ACE measures to examine the impact of types of ACEs and sexual abuse severity on sexual well-being and sexual health outcomes for YFFC.

All youth in the child welfare system have experienced some sort of adverse childhood experience and/or trauma, and while the impact of these experiences on youths' mental health is well documented, little research explores their impact on the youths' overall sexual wellbeing or sexual outcomes. Further, much of the existent research on the impact of child abuse, neglect, home instability, and other adverse childhood situations considers adverse experiences as a singular dimension, often using the totality of the Adverse Childhood Experiences (ACEs) rather than differentiating among types of experiences. When considering sexual abuse, many studies use a single prompt, asking about a history of sexual abuse or victimization rather than taking into account various aspects of sexual abuse. To better understand the differential impact of adverse experiences and the severity of sexual abuse experiences on sexual well-being, this study evaluated the level to which both broad and singular measures of adverse childhood experiences and sexual abuse predicted sexual well-being among a sample of youth formerly in the foster care system (YFFC).

Adverse Childhood Experiences in the Lives ofYouth in the Foster Care System

In 2017, there were close to 443,000 youth under age 20 in the foster care system (YFCS) in the United States (Children's Bureau, 2018). YFCS are differentiated from other youth in the child welfare system by being placed in an out-of-home placement. Examples of these types of placements include a foster home, kinship care (an out-of-home placement with a relative), a group home, a residential facility, and an emergency shelter, though there are other options as well. The most common reasons for entry into the foster care system...