Published in the in July, the study looked at patterns of risky sexual behavior among heterosexual men aged 18 to 25, including some who self-reported using abusive and/or controlling behaviors in their relationships and others who didn’t.

The research found that men who were physically and sexually abusive to women were more likely than non-abusive men to engage in behaviors that exposed them and their partners to sexually transmitted infections, such as avoiding condoms and not being monogamous.

Conversely, men who were not physically or sexually abusive, but who used controlling behavior such as dictating who their partners could see or what they wore, were no more likely to engage in risky sexual behaviors than men who were not controlling.

The researchers conducted the study to better understand the link between heterosexual relationship violence, which affects women disproportionately, and sexual risk, since heterosexual sex remains the primary means of HIV transmission to women.

Prior research has focused on the link between relationship violence and sexual risk among women, but relatively little is known about the specific sexual behaviors of the men in those relationships, lead author said.

“There’s surprisingly little research about heterosexual men in the sexual health field,” said Casey, an associate professor of social work at the . “The research tends to focus on women, and men who have sex with men. I think we make a lot of assumptions about what heterosexual men believe and do.”

Co-author Katherine Querna, a Ph.D. student at the 91̽��School of Social Work in Seattle, said the researchers wanted to parse out individual sexual and abusive behaviors to provide a more nuanced picture of how specific types of abuse may influence sexual risks. For example, she said, researchers expected to find that men who reported using controlling behavior only would exhibit an elevated level of sexually risky behavior, but that wasn’t the case.

“Sexuality is a venue through which people who use abuse can control their partners, so isolating out those behaviors might help us to understand that,” she said.

To recruit for the study, researchers placed ads on Facebook and Craigslist showing racially and ethnically diverse heterosexual couples, and invited men aged 18 to 25 across the U.S. to share their views on “a web survey about relationships with women.”

The study’s 300-plus respondents, who were paid $40 each for participating, were asked whether they used abusive or controlling behaviors in their relationships, and about their sexual behaviors — for example, their number of intimate partners and whether they paid for sexual services.

The study uncovered “disturbingly high” rates of abusive and controlling behaviors. About 37 percent of participants reported using physically aggressive behavior toward their partners, and almost 29 percent said they’d used sexual coercion in their relationships. A majority — 55 percent — acknowledged using controlling behaviors, either alone or in combination with other abusive behaviors. The finding suggests that such behavior might not be uncommon among young men, Casey said.

“We need to understand more about the degree to which controlling behaviors are normative or accepted in this age group,” she said.

Overall, Casey said, the findings highlight the need to consider a broad range of sexual behaviors in domestic violence and sexual risk prevention programs, and to improve sexual risk screening and education in treatment programs for domestic violence perpetrators and victim services alike.

“This reinforces the idea that when we try to assess for sexual risk, we have to look at a lot of different sexual behaviors and motivators,” she said. “If we just look at condom use or monogamy, we might miss the boat and may not understand someone’s exposure to sexual risk.”

Other co-authors, all from 91̽��social work, are research scientists , Blair Beadnell and Marilyn Hoppe; research professor ; and professor .

“In other words, people are as likely to smoke whether or not they were sexually or physically abused, but they’re inclined to smoke more if they were abused and have a history of smoking,” said , a professor in the 91̽��School of Social Work.

The paper is published online in the .

Herrenkohl and co-authors probed the Lehigh Longitudinal Study, which began in the mid-1970s. Participants were recruited from child welfare abuse and protective service programs, as well as day care programs, private nursery programs and Head Start classrooms in Eastern Pennsylvania.

91̽��researchers looked specifically for any connection between physical or sexual abuse and adolescent and adult smoking. They found that boys who had experienced either type of abuse and were smokers, smoked more than those who hadn’t been abused as a child. For girls who smoked, only those who had been sexually abused smoked more as adolescents. That frequency of adolescent smoking by both girls and boys, in turn, led to increased smoking in adulthood, especially among women.

Lead author , a doctoral candidate in social work, found the difference between boys and girls to be one that requires more study.

“There may be other factors at work that we need to disentangle,” she said. “I think the big ‘Aha’ finding is the one on gender differences. Hopefully this will encourage other researchers to look at gender differences in smoking among teens and adults.”

In the Lehigh study, slightly more than 50 percent of the participants said they had smoked in adolescence – that’s about five times the national average for children ages 12-17. Fifty-seven percent of males and 44 percent of females reported smoking in adolescence. Researchers said they don’t know why the rate of smoking was so high in this study. Herrenkohl theorizes that the reasons could have been socioeconomic, geographical, or the fact that participants in this study were already at relatively high risk.

When study participants were evaluated as adults, 49 percent reported smoking in the past year (at nearly equal rates for men and women).

Kristman-Valente said what is of great concern is the fact that so many women who were abused as children were smoking while raising children, and that women who smoke frequently also are less successful in smoking cessation programs.

Since tobacco use often begins in adolescence, researchers say it’s important that public policies are in place to try to prevent kids from lighting up a cigarette in the first place.

“Early adversity can persist throughout a person’s life, so early intervention or prevention of child abuse can potentially lead to long-term public health benefits,” Kristman-Valente said. “I hope our findings encourage more focus on the connection between child maltreatment and smoking in particular. Not many people look at this consequence, even though smoking is the number one cause of preventable death in the U.S.”

The other co-author is , a 91̽��research assistant professor in social work. The research was funded by the , , the , and the .

###

For more information, contact Kristman-Valente at ankv@uw.edu, or Herrenkohl at 206-221-7873 or tih@uw.edu.

The research team analyzed responses collected in a 2010 Washington state survey of more than 24,000 public school students in grades eight through 12. The study found that 14 percent, 11 percent and 9 percent of male students in grades 8, 10, and 12 respectively reported being bullied because of perceived sexual orientation. For female students in those grades, the numbers were 11 percent, 10 percent and 6 percent respectively.

“These findings underscore the need for early prevention efforts before 10^th grade,” wrote the authors.

Being bullied because of perceived sexual orientation was linked to lower quality of life scores and increased the odds of depressed mood or consideration of suicide. Moreover, the size of these associations was greater than being bullied for other reasons

”Youth at this age group are extremely vulnerable to the effects of bullying when they are perceived rightly or wrongly to be gay, lesbian or bisexual. The effects are profound for many youth struggling with issues of identity and self-esteem,” said Patrick, principal investigator of the study.

“Bully-prevention or harm-reduction programs must address bullying because of perceived sexual orientation. All youths are entitled to safe school environments and support is essential for those who are most vulnerable to being bullied because of perceived sexual orientation,” the study concluded.

Read the in the American Journal of Public Health.

###