HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania

Chiang, Laura; Chen, Jieru; Gladden, Matthew; Mercy, James A.; Kwesigabo, Gideon; Mrisho, Fatma; Dahlberg, Linda L.; Nyunt, Myo Zin; Brookmeyer, Kate A.; Vagi, Kevin J.

doi:10.1521/aeap.2015.27.5.474

Cited by 15 publications

(7 citation statements)

References 40 publications

(47 reference statements)

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“…8 In particular, CT is associated with depression in adulthood 9 and is linked to greater risk for HIV acquisition through increased engagement in high-risk behavior. 10,11 It has been estimated that > 50% of HIV-infected individuals have experienced CT, in comparison with 20-33% of HIV-uninfected individuals. [12][13][14][15] Long-term studies have suggested that certain symptoms of depression associated with CT may be linked to interpersonal dysfunction as well as to decreased peer acceptance.…”

Section: Introductionmentioning

confidence: 99%

The role of social support in the association between childhood trauma and depression among HIV-infected and HIV-uninfected individuals

et al. 2018

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Childhood trauma (CT) - emotional, physical or sexual abuse, or emotional or physical neglect - has been associated with HIV infection and can lead to poor health outcomes and depression in adulthood. Though the impact of CT on depression may be decreased by social support, this may not be true of individuals living with HIV, due to the additive traumatic effects of both CT and acquisition of HIV. This study examined social support, depression, and CT among HIV-infected (n = 134) and HIV-uninfected (n = 306) men and women. Participants (N = 440) were assessed regarding sociodemographic characteristics, CT, depression, and social support. Participants were racially and ethnically diverse, 36 ± 9 years of age on average, and 44% had an income of less than USD$500 a month. Among HIV-uninfected individuals, social support explained the association between depression in persons with CT ( b = 0.082, bCI [0.044, 0.130]). Among HIV-infected individuals, after accounting for sociodemographic characteristics, social support did not explain the association between depression and CT due to lower levels of social support among HIV-infected individuals [95% CI: -0.006, 0.265]. The quality of social support may differ among HIV-infected persons due to decreased social support and smaller social networks among those living with HIV. Depressive symptoms among those living with HIV appear to be less influenced by social support, likely due to the additive effects of HIV infection combined with CT.

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Section: Introductionmentioning

confidence: 99%

The role of social support in the association between childhood trauma and depression among HIV-infected and HIV-uninfected individuals

et al. 2018

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“…Evidence on this could have implications for how PrEP is offered to young people and whether a history of trauma would need to be taken into account when providing PrEP. We also hypothesise that probable PTSD may increase sexual risk behaviours associated with HIV risk, as has been previously demonstrated in other sub-Saharan African settings specifically for trauma due to sexual violence [ 13 ].…”

Section: Introductionmentioning

confidence: 76%

“…Among young people in SSA, there is some, albeit inconclusive, evidence that common mental disorders such as depression and anxiety, and prior exposure to trauma including trauma due to sexual violence, may increase HIV-risk behaviours [ 13 , 14 ] and HIV acquisition [ 15 ], and reduce HIV treatment adherence and outcomes [ 16 , 17 ]. They may also impact adherence to PrEP for prevention of HIV, although evidence is mixed: a study in men who have sex with men and transgender women including participants from South Africa found that depression did not contribute to decreased adherence to daily PrEP on a population scale [ 18 ], but studies in Kenya and Uganda [ 19 ], and South Africa [ 20 ] found that depression was associated with poor adherence to daily PrEP among women but not among men.…”

Section: Introductionmentioning

confidence: 99%

Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe

et al. 2022

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Background It is not known whether post-traumatic stress disorder (PTSD) increases HIV-risk behaviours among young people in sub-Saharan Africa. We assessed associations of PTSD symptoms with sexual behaviour, HIV risk perception, and attitudes towards PrEP among young people taking part in the CHAPS community survey. We hypothesised that PTSD symptoms would increase sexual behaviours associated with HIV risk, hinder PrEP uptake and influence preference for daily versus on-demand PrEP. Methods Young people without HIV, aged 13–24 years, were purposively recruited in Johannesburg and Cape Town in South Africa, Wakiso in Uganda, and Chitungwiza in Zimbabwe, and surveyed on socio-demographic characteristics, PrEP knowledge and attitudes, sexual behaviour, HIV perception and salience, and mental health. PTSD symptoms were measured using the Primary Care PTSD Screen for the Diagnostic and Statistical Manual of Mental Disorders 5 (PC-PTSD-5). Logistic and ordinal logistic regression was used to assess associations between PC-PTSD-5 score and socio-demographic characteristics, sexual behaviour, HIV risk perception, PrEP attitudes, and substance use, adjusting for age, sex, setting, depression and anxiety. Results Of 1330 young people (51% male, median age 19 years), 522 (39%) reported at least one PTSD symptom. There was strong evidence that having a higher PC-PTSD-5 score was associated with reported forced sex (OR 3.18, 95%CI: 2.05–4.93), self-perception as a person who takes risks (OR 1.12, 95%CI: 1.04–1.20), and increased frequency of thinking about risk of HIV acquisition (OR 1.16, 95%CI: 1.08–1.25). PTSD symptoms were not associated with willingness to take PrEP, preference for on-demand versus daily PrEP, or actual HIV risk behaviour such as condomless sex. Conclusions Symptoms consistent with probable PTSD were common among young people in South Africa, Uganda and Zimbabwe but did not impact PrEP attitudes or PrEP preferences. Evaluation for PTSD might form part of a general assessment in sexual and reproductive health services in these countries. More work is needed to understand the impact of PTSD on HIV-risk behaviour, forced sex and response to preventive strategies including PrEP.

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“…Thus, a deeper understanding of lifetime sexual violence (LSV) among young females in this country is imperative especially given its high prevalence and the sequelae of this form of violence. LSV is associated with higher risk for sexually transmitted infections (STIs)/HIV, unwanted pregnancy, mental distress, and suicidal thoughts at the individual level, and slow socioeconomic development and well-being at the national level (Brown et al, 2009;Chiang et al, 2015;NPopC et al, 2016). Extant literature has highlighted factors that increase LSV risk (Abeid et al, 2014;Lowry et al, 2017;Mwangi et al, 2015;WHO, 2012).…”

Section: Introductionmentioning

confidence: 99%

Sexual Violence Experience Among Nigerian Girls and Young Women: What Are the Roles of Early Sexual Debut, Multiple Sex Partnerships, and Traditional Gender Role Beliefs?

Brown

Annor

Swahn

et al. 2020

J Interpers Violence

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In Nigeria, one in four females has experienced some form of sexual abuse. Therefore, it is imperative to examine risk factors associated with sexual violence victimization of Nigerian girls and young women to identify targets for prevention and help stakeholders prioritize response efforts. The present article focuses on secondary data analyses of 1,766 females, aged 13 to 24, interviewed in the population-based 2014 Nigeria Violence Against Children Survey. The outcome of interest is lifetime sexual violence (LSV). Several potential predictors were explored: beliefs about gender roles related to sex, early sexual debut (aged <16 years), and multiple sex partners in the past 12 months. Other risk factors assessed were age, ethnicity, religion, education, marital status, and employment. Logistic regression analyses estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results revealed that females who endorsed beliefs about patriarchal sexual decision-making (AOR = 2.1, 95% CI = [1.28, 3.32]) or ever attended school (AOR = 2.4, 95% CI = [1.35, 4.34]) were more likely to report experiencing LSV. Prevention programs that target traditional norm beliefs about gender and sexuality have the potential to influence sexual violence in Nigeria. In addition, school attendance may expose females to potential perpetrators. Thus, to prevent sexual violence of girls who attend school, implementing safety measures may be beneficial for protecting them while in and traveling to/from school.

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HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania

Cited by 15 publications

References 40 publications

The role of social support in the association between childhood trauma and depression among HIV-infected and HIV-uninfected individuals

The role of social support in the association between childhood trauma and depression among HIV-infected and HIV-uninfected individuals

Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe

Sexual Violence Experience Among Nigerian Girls and Young Women: What Are the Roles of Early Sexual Debut, Multiple Sex Partnerships, and Traditional Gender Role Beliefs?

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