Adverse Childhood Experiences and Their Relationship with Poor Sexual Health Outcomes: Results from Four Cross-Sectional Surveys.

Improving understanding of risk factors for risky sexual behaviour is fundamental to achieve better population sexual health. Exposure to adverse childhood experiences (ACEs) can increase the risk of poor sexual health outcomes, but most research is US-based. This study explored associations between ACEs and poor sexual health outcomes in the UK. Data from four cross-sectional ACE surveys with adult general populations in different regions of the UK from 2013−2015 (n = 12,788) were analysed. Data included participants' demographics, ACE exposure, and four sexual health outcomes: having early sex (<16 years), having an accidental teenage pregnancy, becoming a teenage parent, or having a lifetime diagnosis of a sexually transmitted infection. ACE count was a consistent and significant predictor of all four sexual health outcomes for both males and females, with odds of these outcomes between three and seven times higher for those with 4+ ACEs compared to those with no ACEs. Increased risks of some, but not all, sexual health outcomes were also found with higher residential deprivation, younger age, being of white ethnicity, and being born to a teenage mother. Findings highlight the need for effective interventions to prevent and ameliorate the lifelong effects of ACEs. Trauma-informed relationships and sex education, sexual health services, and antenatal/postnatal services, particularly for teenagers and young parents, could provide opportunities to prevent ACEs and support those affected. Ensuring that those living in deprived areas have access to services and that barriers to uptake are addressed is also key.

Computer-based programmes for the prevention and management of illicit recreational drug use: a systematic review.

The last few decades have seen increasing use of computer-based programmes to address illicit recreational drug use but knowledge about their effectiveness is limited. We conducted a systematic review to examine evidence on these programmes. Eight electronic databases were searched to identify primary research studies evaluating computer-based programmes to prevent or reduce use of illicit recreational drugs. From an initial 3413 extracted studies, 10 were identified for inclusion, covering a range of intervention types, target groups and settings. Universal drug prevention programmes were effective in reducing the frequency of recreational drug use in the mid-term (<12 months), but not immediately post intervention. Programmes targeting recreational drug users showed more inconsistent results but were generally effective in reducing use of drugs both immediately and in the mid-term. Computer-based programmes have the potential for use in addressing recreational drug use when targeted both universally and at illicit drug users, at least in the mid-term. However, longer term evaluations are needed to better understand the duration of effects. Given the benefits that computer-based programmes can have over traditional delivery methods, research is needed to better understand the value of human contact in health interventions and help inform whether, and how much, professional contact should be involved in computer-based programmes.