Relationships between childhood abuse and neglect experience and HIV risk behaviors among methadone treatment drop-outs

Objective: The purpose of this study was to examine the relationships between childhood abuse/neglect experiences (sexual abuse, physical abuse, emotional abuse, and child neglect) and adult life functioning among Methadone Maintenance Treatment Program (MMTP) drop-outs. Method: 432 subjects who dropped out of MMTP were recruited in New York City in 1997-1999. Adult life functioning was measured by HIV drug and sex risk behaviors, Addiction Severity Index (ASI) composite scores, and depression. The χ² tests, t tests, correlation, and multiple logistic regressions were performed to examine the relationships between abuse experiences and adult life functioning. Results: The prevalence of child abuse/neglect history was high among MMTP drop-outs: sexual abuse - 36%; physical abuse - 60%; emotional abuse - 57%; child physical neglect - 66%; all four experiences - 25%. As assessed via ASI composite scores, those who had been abused in childhood had significantly more medical, legal, relationship, and psychological problems than those who had not. Overall, several significant associations were found between the abuse experiences and HIV risk behaviors. Those who had experienced child neglect were more likely to be HIV positive. In multivariate analyses, childhood physical abuse was a significant predictor of having multiple sex partners while depression was significantly related to injection drug use in adulthood (p<.05). There were trends for the relationships between childhood sexual abuse and HIV sex risk behavior (p<.10) and between gender and injection drug use (p<.10). Conclusions: The findings support a need for drug treatment programs that include specialized therapies for those who suffered childhood abuse and neglect experiences.