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. 2019 Oct:96:104074.
doi: 10.1016/j.chiabu.2019.104074. Epub 2019 Aug 21.

Coerced and forced sexual initiation and its association with negative health outcomes among youth: Results from the Nigeria, Uganda, and Zambia Violence Against Children Surveys

Kimberly H Nguyen  1 , Mabel Padilla  2 , Andrés Villaveces  2 , Pragna Patel  3 , Victor Atuchukwu  4 , Dennis Onotu  4 , Rose Apondi  5 , George Aluzimbi  5 , Peter Chipimo  6 , Nzali Kancheya  6 , Howard Kress  2
Affiliations

Coerced and forced sexual initiation and its association with negative health outcomes among youth: Results from the Nigeria, Uganda, and Zambia Violence Against Children Surveys

Kimberly H Nguyen et al. Child Abuse Negl. 2019 Oct.

Abstract

Introduction: Coerced and forced sexual initiation (FSI) can have detrimental effects on children and youth. Understanding health outcomes that are associated with experiences of FSI is important for developing appropriate strategies for prevention and treatment of FSI and its consequences.

Methods: The Violence Against Children Surveys were conducted in Nigeria, Uganda, and Zambia in 2014 and 2015. We examined the prevalence of FSI and its consequences (sexual high-risk behaviors, violence experiences, mental health outcomes, and sexually transmitted infections (STI)) associated with FSI among youth aged 13-24 years in three countries in sub-Saharan Africa.

Results: Over one in ten youth aged 13-24 years who had ever had sex experienced FSI in Nigeria, Uganda, and Zambia. In multivariable logistic regression, FSI was significantly associated with infrequent condom use (OR = 1.4, 95%CI = 1.1-2.1), recent experiences of sexual violence (OR = 1.6, 95%CI: 1.1-2.3), physical violence (OR = 2.2, 95%CI: 1.6-3.0), and emotional violence (OR = 2.0, 95%CI: 1.3-2.9), moderate/serious mental distress (OR = 1.5, 95%CI: 1.1-2.0), hurting oneself (OR = 2.0, 95%CI: 1.3-3.1), and thoughts of suicide (OR = 1.5, 95%CI: 1.1-2.3), after controlling for demographic characteristics. FSI was not statistically associated with engaging in transactional sex, having multiple sex partners, or having a STI.

Conclusion: FSI is associated with infrequent condom use, recent experiences of violence and mental health outcomes among youth in sub-Saharan Africa, which may increase the risk for HIV and other consequences. Developing strategies for prevention is important for reducing the prevalence of FSI and its effects on children and youth.

Keywords: Childhood violence; Coerced and forced sex; Forced sexual initiation; Risk-taking behaviors; Sexual violence.

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References

    1. Campbell R, Dworkin E, & Cabral G (2009). An ecological model of the impact of sexual assault on women’s mental health. Trauma, Violence & Abuse, 10(3), 225–246. - PubMed
    1. Campbell JC, Lucea MB, Stockman JK, & Draughon JE (2013). Forced sex and HIV risk in violent relationships. American Journal of Reproductive Immunology, 69(s1), 41–44. - PMC - PubMed
    1. Centers for Disease Control and Prevention (2017). Critical elements of interviewer training for engaging children and adolescents in global violence research: Best practices and lessons learned from the violence against children survey [Internet]. Atlanta, Georgia: Available from: https://www.cdc.gov/violenceprevention/pdf/vacs/VACS-trainingwhitepaper.pdf.
    1. Chiang LF, Kress H, Sumner SA, Gleckel J, Kawem am a P, & Gordon RN (2016). Violence Against Children Surveys (VACS): Towards a global surveillance system. Injury Prevention, 22(Suppl 1), i1 7–i2 2. - PMC - PubMed
    1. Denison JA, O’Reilly KR, Schmid GP, Kennedy CE, & Sweat MD (2008). HIV voluntary counseling and testing and behavioral risk reduction in developing countries: A meta-analysis, 1990–2005. AIDS and Behavior, 12(3), 363–373. - PubMed

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