Objectives: We examined the relation between childhood sexual abuse and injection drug use initiation among young adult injection drug users.; Methods: We used mixed effect linear models to compare age at first injection among 2143 young injection drug users by first sexual abuse age categories.; Results: The participants were predominantly male (63.3%) and White (52.8%). Mean age and age at first injection were 23.7 and 19.6 years, respectively; 307 participants (14.3%) reported childhood sexual abuse. After adjustment for gender, race/ethnicity, noninjection drug use before first injection drug use, and recruitment site, childhood sexual abuse was independently associated with younger age at first injection.; Conclusions: Childhood sexual abuse was associated with earlier initiation of injection drug use. These data emphasize the need to integrate substance abuse prevention with postvictimization services for children and adolescents.;
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