The Association of Recurrent and Multiple Types of Abuse with Adverse Mental Health, Substance Use, and Sexual Health Outcomes among Out-of-School Adolescent Girls and Young Women in Cape Town, South Africa

Abstract

Although physical and sexual abuse exposure is a well-established risk for poor health, the dimensions of abuse associated with health among socially vulnerable adolescent girls and young women (AGYW) remain underexamined. This article describes associations between combinations of abuse type and timing with mental health, substance use, and sexual risk outcomes among a sample of 499 AGYW (aged 16 to 19) who had left school early and were recruited for a cluster randomized trial in Cape Town, South Africa. Approximately one-third (33.5%; 95% CI: 28.7, 38.6) of participants reported lifetime abuse. Exposure to more than one type of abuse was associated with increased risk of depression (β = 3.92; 95% CI: 2.25, 5.59) and anxiety (β = 3.70; 95% CI: 2.11, 5.28), and greater odds of polydrug use (OR = 2.10; 95% CI: 1.02, 4.34) and substance-impaired sex (OR = 2.17; 95% CI: 1.31, 3.86). Exposure to multiple types of abuse during childhood/early adolescence and again in late adolescence was associated with increased risk of depression (β = 4.65; 95% CI: 3.15, 6.14), anxiety (β = 4.35; 95% CI: 2.70, 6.02), and polydrug use (OR = 2.37; 95% CI: 1.03, 5.73). Findings underscore the need for trauma-informed interventions that reduce mental health, substance use, and sexual risks among AGYW who have experienced multiple forms of abuse and recurrent abuse.

The Associations of Intimate Partner Violence and Non-Partner Sexual Violence with Hypertension in South African Women

“…Finally, the findings demonstrate that mental health problems, such as depression, PTSS, and binge-drinking, completely or partially mediated the associations of different adult abuse exposures with hypertension. Mental health issues and excessive alcohol and other forms of substance use are common among abused women [ 49 , 50 , 51 ], and the latter findings underscore the need to address these problems in this vulnerable population. Together with aiding in their healing following abuse exposures, interventions specifically targeting mental health and problematic alcohol use may prevent or delay the development of hypertension among abused women.…”

Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL): A cross-sectional observational study protocol using respondent driven sampling

“…If enrollment is more rapid, we may hire additional staff. The risk of participant attrition is another challenge, but this will be limited by incorporating recruitment strategies that have been successful with previous studies that focused on PWUD, such as collecting detailed locator information and actively tracking participants between appointments, as well as the provision of reminders and reimbursement [ 64 , 65 ]. COVID-19 also presents challenges in conducting study activities with South Africa having experienced a lengthy lockdown period in 2020 during which research activities were halted.…”

Outcomes of substance use and sexual power among adolescent girls and young women in Cape Town: Implications for structural and cultural differences

“…AGYW who leave school prematurely are at heightened risk for greater poverty, with limited options for financial stability and gainful employment throughout their lifetime ( Carney et al, 2019 ; Myers et al, 2016 ; Myers et al, 2021 ; Wechsberg et al, 2018 ). Leaving school prior to completion increases the likelihood of AGYW engaging in sex trading or dating older partners or men in gangs for basic economic resources or protection ( Carney et al, 2019 ; Gibbs et al, 2018 ; Sawyer-Kurian et al, 2014 ).…”