Adolescent sexual violence is a serious public health concern that may have lasting impacts on the survivor, yet limited longitudinal research on the behavioural and mental health outcomes following sexual victimization exists. To describe the long-term behavioural and mental health outcomes associated with sexual victimization at 14 years of age, and whether these outcomes differed by sex, sexual orientation, and ethnic minority status. This prospective study used data from the Millennium Cohort Study, a nationally representative, longitudinal cohort study of children born in the United Kingdom between 2000 and 2002. Sexual victimization was self-reported when cohort members were 14 years of age, and outcomes (self-harm, suicide attempt, distress, alcohol use, binge drinking, smoking, vaping, and illicit substance consumption) were measured at age 17. Sexual victimization at age 14 was associated with poorer mental health, binge drinking, smoking regularly, vaping, and illicit drug use at age 17. Mental health outcomes differed by sex and these associations were stronger for males than females (self-harm: males RR = 2.4,95%CI: 1.55-3.79, females RR = 1.3,95%CI: 1.10-1.63; distress: males RR = 3.3,95%CI: 1.73-6.24, females RR = 1.4,95%CI: 1.08-1.75). Compared to non-victimized heterosexual adolescents, victimized heterosexual adolescents had nearly twice the risk of self-harm (RR = 1.87,95%CI: 1.40-2.46) and distress (RR = 2.09,95%CI: 1.46-2.96). Victimized adolescents belonging to an ethnic minority group showed three times the risk of distress (RR = 3.35,95%CI: 1.70-6.61) and non-ethnic minorities were more likely to vape (RR = 1.56, 95%CI:1.08-2.25). Adolescents who experience sexual victimization are at increased risk of poorer mental health later in adolescence.
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