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Targeted screening for sexual abuse is needed for social workers to accurately identify those at risk. Drawing on a cumulative disadvantage framework, this study investigates how parental addictions, parental mental illness, and exposure to domestic violence, both individually and cumulatively, are associated with childhood sexual abuse (CSA). Two waves of regionally representative data were analyzed. Bivariate and logistic regression analyses were conducted using the 2010 Brief Risk Factor Surveillance Survey (BRFSS) (n = 9,241 men, n =