Gender differences in the prevalence of adverse childhood experiences and health-risk behaviors among Saudi Arabian adults

Objectives: Adverse Childhood Experiences (ACEs) have been found to be linked to health-risk behaviors in adulthood. Nevertheless, little research has been conducted to explore gender differences in the prevalence of ACEs and... [ view full abstract ]

Objectives: Adverse Childhood Experiences (ACEs) have been found to be linked to health-risk behaviors in adulthood. Nevertheless, little research has been conducted to explore gender differences in the prevalence of ACEs and health-risk behaviors. The aim of this study is to identify the gender differences in the prevalence of ACEs and health-risk behaviors among adults.

Methods: A cross-sectional, national survey utilizing Adverse Childhood Experiences International Questionnaire (ACE-IQ), supported by a grant from King Abdullah International Medical Research Center (KAIMRC) was conducted in 13 regions of Saudi Arabia. Adults (N=10,156) aged ≥18 years were invited to participate. Chi-square analysis was undertaken to examine the relationship between gender and prevalence of ACEs.

Results: Participant’s mean age 34.3±11.3 years, and 52% male. Thirty eight percent college educated, employed (51%), and married (59%). Prevalence of neglect (41%), psychological abuse (19%), physical abuse (13%), and sexual abuse (14%). Twenty percent reported no ACEs while 80% reported at least 1 ACE. Of these, 29% reported ≥4 ACEs. Exposure to ≥4 ACEs were found to be higher in males whereas low scores of ACEs were found to be higher in females (p<0.05). In terms of health-risk behaviors, males were more likely to smoke (57% vs. 17%, p<0.05), drinking alcohol (12% vs. 5%, p<0.05), using drugs (11% vs. 5%, p<0.05), and had pre-marital sexual relationship (26% vs. 8%, p<0.05).

Conclusions: Further research is needed to determine plausible pathways linking ACEs and health- risk behaviors among males.