Cumulative victimization and number of sexual partners among youth involved with child welfare: Externalizing and internalizing problems as mediators

Objectives: There is some evidence linking child maltreatment and higher number of sexual partners. However, limited knowledge exists regarding potential mediating mechanisms linking these two variables, particularly related to child protective services (CPS) involved youth. Compared to youth in the general population, CPS-involved youth are at greater risk of having higher numbers of sexual partners. We examined the unique and cumulative effects of child physical abuse, sexual abuse, emotional abuse, and domestic violence exposure on number of sexual partners. We also examined indirect relationships between cumulative victimization and number of sexual partners, testing externalizing and internalizing problems as potential mediators. Method: We used three waves of longitudinal data from 11 to 17-year-old youth (n = 1042) who participated in the second cohort of the National Survey of Child and Adolescent Well-being. Data were analyzed using path analysis with bias-corrected bootstrapped confidence intervals. Child maltreatment data were collected at Wave 1. Data on number of sexual partners were collected from youth during Waves 1 and 3. Study analyses included the highest number of sexual partners reported in either wave. Results: We found no statistically significant unique relationship between any single maltreatment type and number of sexual partners. However, cumulative victimization (experiencing two maltreatment types compared to zero maltreatment type) at Wave 1 was significantly associated with more internalizing, B = 0.30, 95% CI [0.01, 0.59], and externalizing problems at Wave 2, B = 0.66, 95% CI [0.37, 0.96]. Additionally, externalizing problems mediated the association between cumulative victimization and number of sexual partners, unstandardized indirect effect = 0.26, 95% CI [0.06, 0.43]. Conclusions: CPS interventions should target high numbers of sexual partners among youth with cumulative victimizations by targeting externalizing problems.