RESUMO
OBJECTIVE: To describe associations between childhood violence and forced sexual initiation in young Malawian females. STUDY DESIGN: We analyzed data from 595 women and girls who were 13-24 years old who ever had sex and participated in Malawi's 2013 Violence Against Children Survey, a nationally representative household survey. We estimated the overall prevalence of forced sexual initiation and identified subgroups with highest prevalences. Using logistic regression, we examined childhood violence and other independent predictors of forced sexual initiation. RESULTS: The overall prevalence of forced sexual initiation was 38.9% among Malawian girls and young women who ever had sex. More than one-half of those aged 13-17 years at time of survey (52.0%), unmarried (64.6%), or experiencing emotional violence in childhood (56.9%) reported forced sexual initiation. After adjustment, independent predictors of forced sexual initiation included being unmarried (aOR, 3.54; 95% CI, 1.22-10.27) and any emotional violence (aOR, 2.47; 95% CI, 1.45-4.24). Those experiencing emotional violence alone (aOR, 3.04; 95% CI: 1.01-9.12), emotional violence in combination with physical or nonpenetrative sexual violence (aOR, 2.50; 95% CI, 1.23-5.09), and emotional violence in combination with physical and nonpenetrative sexual violence (aOR, 2.61; 95% CI, 1.20-5.67) had an increased independent odds of forced sexual initiation. CONCLUSIONS: Experiences of forced sexual initiation are common among Malawian females. Emotional violence is strongly associated with forced sexual initiation, alone and in combination with other forms of childhood violence. The relationship between emotional violence and forced sexual initiation highlights the importance of comprehensive strategies to prevent childhood violence.
Assuntos
Delitos Sexuais/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Violência/estatística & dados numéricos , Adolescente , Estudos Transversais , Características da Família , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Malaui/epidemiologia , Prevalência , Estupro/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
Sexual violence against children erodes the strong foundation that children require for leading healthy and productive lives. Globally, studies show that exposure to violence during childhood can increase vulnerability to a broad range of mental and physical health problems, ranging from depression and unwanted pregnancy to cardiovascular disease, diabetes, and sexually transmitted diseases, including human immunodeficiency virus (HIV). Despite this, in many countries, the extent of sexual violence against children is unknown; estimates are needed to stimulate prevention and response efforts and to monitor progress. Consequently, CDC, as a member of the global public-private partnership known as Together for Girls, collaborated with Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe to conduct national household surveys of children and youth aged 13-24 years to measure the extent of violence against children. The lifetime prevalence of experiencing any form of sexual violence in childhood ranged from 4.4% among females in Cambodia to 37.6% among females in Swaziland, with prevalence in most countries greater than 25.0%. In most countries surveyed, the proportion of victims that received services, including health and child protective services, was ≤10.0%. Both prevention and response strategies for sexual violence are needed.
Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Serviço Social/estatística & dados numéricos , Adolescente , Camboja/epidemiologia , Criança , Essuatíni/epidemiologia , Feminino , Haiti/epidemiologia , Humanos , Quênia/epidemiologia , Malaui/epidemiologia , Masculino , Prevalência , Tanzânia/epidemiologia , Adulto Jovem , Zimbábue/epidemiologiaRESUMO
In this study, correlates of HIV sexual protective behavior, in the form of condom use, were examined within a population of urban women identified as at increased heterosexual risk for HIV infection. Hierarchical regression analyses were used to analyze data collected via structured interviews for 187 Puerto Rican women recruited from the waiting areas of a comprehensive health clinic in the Bronx, New York. Increased condom use with primary partners was associated with higher levels of mastery, more non-Hispanic acculturation, and greater adherence to traditional female gender roles. Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self-efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.
Assuntos
Atitude Frente a Saúde/etnologia , Infecções por HIV/prevenção & controle , Hispânico ou Latino/etnologia , Sexo Seguro/etnologia , Mulheres/psicologia , Aculturação , Adulto , Preservativos , Feminino , Identidade de Gênero , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino/educação , Humanos , Controle Interno-Externo , Modelos Psicológicos , Motivação , Análise Multivariada , Cidade de Nova Iorque , Porto Rico/etnologia , Análise de Regressão , Assunção de Riscos , Autoeficácia , Inquéritos e Questionários , População Urbana , Mulheres/educaçãoRESUMO
We examined the association of primary or nonprimary sexual partner relationship status on sexual risk behaviors, including condom use, among Latina women who are at self-disclosed increased heterosexual risk for human immunodeficiency virus (HIV) infection. Data were collected via structured interviews of 187 Puerto Rican women, aged 18-35, who attended a health clinic in the Bronx, New York. Approximately 13% of participants reported sexual activities with both primary and nonprimary sexual partners during the 6 months prior to the interview. Primary or nonprimary sexual partner status was associated with significant differences in frequency of condom use during anal sex and oral-penile sex, with more frequent condom use reported during these sexual activities with nonprimary sexual partners. Thus, potential contextual differences associated with primary or nonprimary relationship status may represent important factors to consider when designing interventions to facilitate HIV-protective behaviors among populations of urban women identified at increased heterosexual risk for HIV infection.