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. 2025 Sep 17;16(1):750.
doi: 10.4102/jphia.v16i1.750. eCollection 2025.

Understanding sexual violence: Perspectives from an adolescent HIV prevention study

Nadia Ahmed  1   2 , Emily Webb  3 , Richard Muhumuza  4 , Andrew S Ssemata  4 , Millicent Atujuna  2 , Lynda Stranix-Chibanda  5   6 , Teacler Nematadzira  5 , Janan J Dietrich  7 , Gugulethu Tshabalala  7 , Stefanie Hornschuh  7 , Helen A Weiss  3 , Janet Seeley  4   8   9 , Julie Fox  10
Affiliations

Understanding sexual violence: Perspectives from an adolescent HIV prevention study

Nadia Ahmed et al. J Public Health Afr. .

Abstract

Background: Sub-Saharan Africa has a high prevalence of sexual violence in young women, with less data on young men.

Aim: We investigated the prevalence of forced sex among adolescents and young people and described factors putting them at risk of sexual violence.

Setting: The study was conducted in South Africa, Uganda and Zimbabwe.

Methods: We conducted a cross-sectional, structured survey among 1330 13-24-year-old male and female participants. Logistic regression models were used to estimate odds ratios for associations with forced sex, adjusting for site, sex and age. Sixty in-depth interviews and 24 group discussions were also conducted. Data were transcribed, translated and analysed using thematic framework analysis.

Results: Seventy-six out of 1326 participants (6%) reported forced sex in the last 6 months. Forced sex was most commonly reported in Entebbe versus other sites, female than male participants, and 18-24 years than 13-18 years. Associations were seen with younger sexual debut (adjusted odds ratio [aOR]: 0.89; 95% confidence interval [CI]: 0.81, 0.98), ever having transactional sex (aOR: 2.18; 95% CI: 1.19, 4.02), risk-taking (aOR: 3.51; 95% CI: 1.99, 6.19), depression (aOR: 3.20; 95% CI: 1.69, 6.06), anxiety (aOR: 2.07; 95% CI: 1.08, 3.96) and binge drinking (aOR: 2.66; 95% CI: 1.33, 5.36), and strong association with forcing someone to have sex (aOR: 7.54; 95% CI: 3.68, 15.46). Qualitative data support these results.

Conclusion: Our findings identify risks similar to those for sexual violence.

Contribution: We suggest protection strategies to police times and places of risk are developed, and addressed in economic and legal country specific guidance.

Keywords: HIV; prevention; rape; sexual assault; sexual violence.

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Conflict of interest statement

The authors reported that they received funding from the European Union, which may be affected by the research reported in the enclosed publication. The authors have disclosed those interests fully and have implemented an approved plan for managing any potential conflicts arising out of their involvement. The terms of these funding arrangements have been reviewed and approved by the affiliated University in accordance with its policy on objectivity in research.

Figures

FIGURE 1
FIGURE 1
Belsky’s framework.
See this image and copyright information in PMC

References

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