Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention.
Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention.
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DOI：
10.1186/s12889-016-3832-0
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发表时间：
2016-11-25
影响因子：
4.5
通讯作者：
Kaida A
中科院分区：
文献类型：
--
作者：
Closson K;Dietrich JJ;Nkala B;Musuku A;Cui Z;Chia J;Gray G;Lachowsky NJ;Hogg RS;Miller CL;Kaida A
青少年创伤暴露与艾滋病毒流行风险相关。我们测量了生活在南非索韦托艾滋病毒高流行地区的青少年中按性别划分的终生患病率、类型和创伤经历的相关性。使用 Botsha Bophelo 青少年健康调查 (BBAHS) 的数据，使用改良的儿童创伤事件筛查量表 (TESI-C) 量表（19 项，研究 alpha = 0.63）评估了青少年（14-19 岁）中“曾经”经历过创伤事件的患病率。我们评估了自我报告的总体和按性别经历的潜在创伤事件 (PTE) 的数量。性别分层多变量逻辑回归模型评估了“高 PTE 分数”（≥7 PTE）的独立相关性。总体而言，共有 767/830 (92%) 名参与者（58% 为青春期女性）。几乎所有人 (99.7%) 都报告至少经历过一次 PTE。 PTE 中位数为 7 [Q1、Q3：5-9]，没有性别差异 (p = 0.19)。青春期男性报告了更多的暴力 PTE（例如，“在社区中看到暴力行为”），而女性报告了更多与艾滋病毒/艾滋病相关的非暴力 PTE（例如，“家庭成员或亲近的人死于艾滋病毒/艾滋病”）。高 PTE 评分与青少年男性和女性的高粮食不安全水平独立相关（aOR = 2.63，95%CI = 1.36-5.09；aOR = 2.57，95%CI = 1.55-4.26）。对于男性来说，高 PTE 分数也与年龄较大相关（aOR = 1.40/年，95% CI = 1.21-1.63）；最近搬到索韦托（aOR = 2.78，95%CI = 1.14-6.76）。在女性中，使用 CES-D 量表，高 PTE 评分与抑郁症相关（aOR = 2.00，95%CI = 1.31-3.03），以及安全套使用不一致与没有性经历（aOR = 2.69，95%CI = 1.66-4.37）。这项研究中几乎所有青少年都经历过创伤，PTE 类型和相关性存在性别差异，但患病率没有差异。 PTE 的暴露情况沿着社会和性别轴分布。在青春期女性中，抑郁症和不经常使用安全套的相关性提示了艾滋病毒风险的途径。针对青少年的艾滋病毒预防干预措施必须通过扩大性别变革、以青年为中心、了解创伤的综合艾滋病毒和心理健康服务来解决创伤和艾滋病毒的并发流行病。本文的在线版本 (doi:10.1186/s12889-016-3832-0) 包含补充材料，可供授权用户使用。
Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of “ever” experiencing a traumatic event among adolescents (aged 14–19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of ‘high PTE score’ (≥7 PTEs). Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., “seen an act of violence in the community”) whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., “family member or someone close died of HIV/AIDS”). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services. The online version of this article (doi:10.1186/s12889-016-3832-0) contains supplementary material, which is available to authorized users.
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影响因子：
5
作者：
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影响因子：
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影响因子：
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影响因子：
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