Background:
Childhood sexual violence is associated with adverse psychiatric and behavioral health outcomes, including substance use; however, little is known about these relationships among South Asian women attending U.S. colleges and universities. This study examined the prevalence of childhood sexual violence and its association with alcohol, nicotine, and non-prescription drug use in this understudied population. Methods: A cross-sectional online survey was conducted among 673 South Asian women enrolled in U.S. colleges and universities between February and March 2025. Childhood sexual violence was assessed using two items adapted from the Adverse Childhood Experiences questionnaire. Substance use outcomes included frequent alcohol consumption, current nicotine use, and lifetime non-prescription drug use during college. Multivariable logistic regression models estimated adjusted odds ratios (AORs) and 95% confidence intervals (CIs), controlling for age, birthplace, HHS region, distance from parents, year in college, relationship status, and sexual orientation. Results: Overall, 27.0% of respondents reported childhood sexual violence. Childhood sexual violence was independently associated with greater odds of non-prescription drug use (AOR = 4.14, 95% CI: 2.64–6.47), nicotine use (AOR = 2.79, 95% CI: 1.87–4.17), and frequent alcohol consumption (AOR = 2.62, 95% CI: 1.71–4.02). LGBTQIA+ identity was associated with higher odds of non-prescription drug use and nicotine use, while relationship status was associated only with frequent alcohol consumption. Conclusions: Childhood sexual violence was a strong and consistent correlate of substance use among South Asian women attending U.S. colleges and universities. These findings underscore the importance of trauma-informed, culturally responsive screening and behavioral health interventions that address the unique needs of South Asian women during emerging adulthood.
Keywords: South Asian women; Childhood Sexual Violence; Substance Use; Trauma-Informed Care
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