Gender Differences in the Association Between Adverse Childhood Experiences and Drug Use: Findings From a Community-Based Survey in China

Advances in Public Health

卷:2026

Research Article

Hongyun Fu¹  Elizabeth Monk-Turner²  Xiushi Yang² 

[1] Sociology and Criminal Justice, Old Dominion University, Norfolk, 23529, Virginia, USA, odu.edu

[2] Community Health and Research Division, Pediatrics Department, Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Science, Old Dominion University, Norfolk, 23510, Virginia, USA, evms.edu

关键词: adverse childhood experiences;    drug use;    gender disparity;    population-based;    probability sampling;    trauma-informed care;   

DOI  :  10.1155/adph/5189161

 received in 2025-04-17, accepted in 2026-05-07,  发布年份 2026

来源: Hindawi Publishing Corporation

【 摘 要 】

BackgroundWhile adverse childhood experiences (ACEs) are widely recognized risk factors for behavioral health problems, including drug use, prior research has largely been conducted in Western countries, focused primarily on males, and relied on convenience samples without comparison groups of nonusers. Limited work has examined the impact of ACEs on drug use in non-Western contexts. This study examines gender differences in the relationship between ACEs and drug use in China, using data from a population-based probability sample survey.MethodsCross-sectional data were collected in 2019 from one city in Yunnan Province in Southwest China and one city in Guangdong Province through baseline population-based surveys of people who use drugs (PWUD, n = 848) and people who do not use drugs (PNUD, n = 1455), recruited using a three-stage stratified probability sampling method. Multivariable logistic regression was employed to examine the association between ACEs and drug use and to assess the moderating effect of gender. Multivariable logistic regression analyzed the association between ACEs and drug use and tested gender as a moderating factor. Odds ratios and 95% confidence intervals were calculated.ResultsACEs were highly prevalent, with a dose–response relationship observed. Among PWUD, 73.0% reported at least one ACE, compared to 49.99% of PNUD (p <0.001). Additionally, 19.25% of PWUD experienced ≥3 ACEs, versus 3.94% of PNUD (p <0.001). ACEs significantly increased drug use risk (≥3 ACEs: OR = 4.82, 95% CI: 3.67–6.34), with stronger effects in females (OR = 6.31, 95% CI: 4.02–8.76) than males (OR = 3.95, 95% CI: 2.89–5.41).ConclusionThe interplay between ACEs, gender, and drug use underscores the need for gender-sensitive and trauma-informed interventions. Integrating early ACE screening, family-based interventions to strengthen relationships and coping, and community-based support systems is essential for effective drug use prevention and harm reduction.

【 授权许可】

CC BY   
Copyright © 2026 Hongyun Fu et al. Advances in Public Health published by John Wiley & Sons Ltd. 2026

【 图 表 】

Figure 3