CSA has been associated with the performance of risky sexual behaviors in adolescence and youth (Senn et al., 2008). Adolescence is a critical period, in which sexual activity begins and sexual behavior is subject to a multitude of influences (e.g., friends, media, pornography) that can promote a decrease in the control of the situation and increased vulnerability (Spanish Foundation for AIDS Research and Prevention, 2003). Some characteristic aspects of sexuality during adolescence may include low risk perception (Castro and Santos-Iglesias, 2016), alcohol and other drug use, lack of planning of sexual intercourse, the romantic ideals characteristic of this stage (Jones and Furman, 2011), scarce eroticization of condom use (DiClemente et al., 2004), or poor skills to negotiate condom use and perform safe sexual behaviors (Santos-Iglesias and Sierra, 2012).

Vulnerability is even greater if, to these obstacles to engage in protective sexual behavior that exist during adolescence, is added the fact that the adolescent has been a victim of CSA. Some research concludes that people who have suffered an episode of CSA present earlier initiation of consensual sex with penetration (Thornton and Veenema, 2015; Gray and Rarick, 2018), more sexual partners (Senn et al., 2012, 2017; Walsh et al., 2013), more inconsistent condom use (Senn et al., 2012, 2017), or increased drug use in sexual relationships (Thornton and Veenema, 2015). All these behaviors imply greater vulnerability to sexually transmitted infections (STI; Homma et al., 2012; Senn et al., 2012) and are usually variables that also predispose one to suffer new episodes of sexual victimization (Bermúdez et al., 2010).

Suffering further episodes of sexual victimization during adolescence and early youth is common among victims of CSA. Authors such as Walker et al. (2017) concluded in their meta-analysis that the prevalence of revictimization reached almost 50% of the cases. Some studies have reported that female victims of CSA are three to five times more likely to suffer further sexual assault than those who have not suffered CSA (Pereda et al., 2016; Godbout et al., 2019).

Some variables have been proposed in the existing literature to explain the CSA-sexual assaults relationship in adulthood (Walker et al., 2017). For example, Santos-Iglesias and Sierra (2012) suggest that this relationship is mediated by three variables: sexual experience, sexual assertiveness, and substance use before intercourse. In terms of sexual experience, it has been established that women who suffered CSA have a larger number of partners, which increases the risk of revictimization due to a probabilistic issue: the more partners, the more likely they are to be aggressive (Arata, 2000).

Regarding sexual assertiveness, authors like Livingston et al. (2007) claim that minors suffering CSA are socialized in a victim role, which makes them less capable of being assertive to reject others’ sexual advances, which influences a possible revictimization. Substance consumption may also mediate this relationship, as these authors have indicated that CSA is a risk factor for increased consumption and this, in turn, is a risk factor for revictimization.

According to this model, CSA can have four negative consequences. First, a traumatic sexualization (Matorin and Lynn, 1998), through which incorrect sexual behavior scripts are developed because negative sexual patterns are rewarded. This may motivate individuals who were sexually abused to have a large number of sexual partners, to wish to engage in risky behaviors, or to have sex in exchange for material rewards (Senn et al., 2012; Walsh et al., 2013). Second, a sense of betrayal (DiLillo and Long, 1999), as the child feels deceived by the abuser or by the reactions of others upon finding out about the abuse. This may be related to the difficulty of trusting others, which, in turn, may influence rejecting stable relationships in favor of multiple and sporadic relationships, with their entailed risk both of performing risky sexual behaviors and possible episodes of sexual victimization (Senn et al., 2008, 2017).

The third element of the model is stigmatization, as the individual feels sexually different, in addition to feeling shame and guilt (Feiring et al., 2001). These feelings can motivate abused people to internalize their role and have multiple partners, as well as to carry out risky behaviors (Senn et al., 2008). Fourth and last, Finkelhor and Browne (1985) refer to the loss of power in their relationships, as they feel that they cannot control their sexual interactions and are incapable of rejecting sex or risky relationships (Gwandure, 2007).

There is evidence that CSA is related to the constructs of the traumatogenic dynamics model (Senn et al., 2012). In addition, the four constructs of the model have been associated with poorer psychological functioning. Higher traumatic sexualization was associated with more anxiety and sexual avoidance and with lower sexual self-esteem (Hazzard, 1993; Matorin and Lynn, 1998); increased feeling of betrayal was associated with more interpersonal problems (Hazzard, 1993); and more stigmatization and powerlessness have been linked to less sexual self-esteem and more distress and depression (Hazzard, 1993). Thus, the TD model is shown to provide an explanation of the consequences of CSA, both psychological and sexual, which can influence the increased performance of risky sexual behaviors and sexual revictimization in adolescence and youth (Walsh et al., 2013).

Fisher and Fisher (1992) developed this theoretical model to explain sexual behavior based on three elements, which can serve to explain the relationship between CSA and the performance of risky sexual behaviors. They suggest that information (on the transmission, prevention, and consequences of STI), motivation (to protect oneself, about safe sex), and behavioral skills (to discuss safe sex with a partner and to use condoms) influence sexual behavior, as several studies have shown (Johnson et al., 2006; Fisher et al., 2014; Jones et al., 2018; Ybarra et al., 2018).

CSA can influence the level of information, motivation, and behavioral skills for safe sex through several mechanisms. In fact, suffering CSA has been linked to less knowledge about STI, fewer favorable attitudes toward safe sex, and fewer behavioral skills and lower self-efficacy (Hall et al., 2008).

Zurbriggen and Freyd (2004) argue that CSA may cause dissociative tendencies, which could interfere with the coding and processing of sexuality-related information. Thus, people who were sexually abused during childhood may have difficulty processing or remembering information about sex, which can lead to gaps in their knowledge about prevention and about risky behaviors.

Similarly, CSA can lead to difficulties in distinguishing fantasy from reality, because many abusers lie or distort reality. Being motivated to have safe sexual practices may require understanding that one is at risk of an STI; if individuals are not capable of objectively assessing the reality of sexual situations, they will not believe that they are vulnerable. Thus, the low or lack of perception of risk can lead to a low or lack of motivation to practice safe sex (Zurbriggen and Freyd, 2004). Finally, individuals who were sexually abused as children may have learned that they cannot control what happens to them, which can lead to low self-efficacy and few skills to negotiate safe sex (Zurbriggen and Freyd, 2004).

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.