Child sexual abuse is a pervasive problem that affects a large percentage of women. Women who report a history of child sexual abuse are more likely to experience a continuum of later violence and a cluster of risk behaviors, presenting an even greater risk for future health problems. Sexually transmitted diseases cause substantial morbidity, can result in long-term consequences, and are a major public health problem. Responsible sexual behavior is a leading health indicator for Healthy People 2010 and STDs are addressed in the objectives of "Improving Health". Studies have suggested that rural women have less access to health care, fewer abuse-related resources, and providers who are less informed about violence. Psychological stress and dissociation have been reported by adult women who have experienced child sexual abuse and may prevent a woman from engaging in protective behaviors related to sexual activities. Because of the number of interconnected variables in this body of literature, the mechanism by which the dissociation does or does not affect safer sex behaviors is not well understood. The proposed cross-sectional descriptive study will explore the variables of a history of child sexual abuse, dissociation, current abuse, substance use, post-traumatic stress disorder behaviors on the outcome of sexual behavior practices of rural women. The aims of this study are to: (Primary Aim)- Explore the influence of a history of child sexual abuse, current abuse, dissociation, substance use, and post-traumatic stress behaviors on safer sex practices of rural women, and (Secondary Aim)- Determine the relationship among the variables of history of child sexual abuse, current abuse, dissociation, substance use and post-traumatic stress behaviors. The sample will be a convenience sample (n=207) of rural women 18 years and older seeking healthcare at a clinic setting. [unreadable] [unreadable] [unreadable]