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
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
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DOI：
10.1016/j.chiabu.2019.104074
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发表时间：
2019-10-01
影响因子：
4.8
通讯作者：
Kress, Howard
中科院分区：
文献类型：
--
作者：
Nguyen, Kimberly H.;Padilla, Mabel;Kress, Howard
简介：胁迫和强迫性行为（FSI）可能对儿童和青少年产生有害影响。了解与FSI经验相关的健康结果对于制定预防和治疗FSI及其后果的适当策略非常重要。方法：2014年和2015年在尼日利亚，乌干达和赞比亚进行了针对儿童的暴力调查。我们研究了FSI的患病率及其后果（性高风险行为，暴力的经验，心理健康的结果，性传播感染（STI））与FSI之间的青年年龄在13-24岁，在撒哈拉以南Africa.Results的三个国家：超过十分之一的青年年龄在13-24岁的人有过性经历FSI在尼日利亚，乌干达和赞比亚。在多变量逻辑回归分析中，FSI与避孕套使用频率低显著相关（OR = 1.4，95%CI = 1.1-2.1），近期有过性暴力经历（OR = 1.6，95%CI：1.1-2.3），身体暴力（OR = 2.2，95%CI：1.6-3.0），和情感暴力（OR = 2.0，95%CI：1.3-2.9），中度/严重精神痛苦（OR = 1.5，95%CI：1.1-2.0）、伤害自己（OR = 2.0，95%CI：1.3-3.1）和自杀念头（OR = 1.5，95%CI：1.1-2.3）。FSI没有统计学相关性交易性行为，有多个性伴侣，或有STI.Conclusion：FSI与不经常使用避孕套，最近的暴力经历和心理健康结果在撒哈拉以南非洲的青年，这可能会增加艾滋病毒和其他后果的风险。制定预防战略对于减少FSI的流行及其对儿童和青少年的影响至关重要。
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.