Childhood sexual violence and HIV risk in Tanzania

HIV and childhood sexual violence: implications for sexual risk behaviors and HIV testing in Tanzania.

Chiang LF, Chen J, Gladden MR, Mercy JA, Kwesigabo G, Mrisho F, Dahlberg LL, Nyunt MZ, Brookmeyer KA, Vagi K. AIDS Educ Prev. 2015 Oct;27(5):474-87. doi: 10.1521/aeap.2015.27.5.474

Prior research has established an association between sexual violence and HIV. Exposure to sexual violence during childhood can profoundly impact brain architecture and stress regulatory response. As a result, individuals who have experienced such trauma may engage in sexual risk-taking behavior and could benefit from targeted interventions. In 2009, nationally representative data were collected on violence against children in Tanzania from 13-24 year old respondents (n = 3739). Analyses show that females aged 19-24 (n = 579) who experienced childhood sexual violence, were more likely to report no/infrequent condom use in the past 12 months (AOR = 3.0, CI [1.5, 6.1], p = 0.0017) and multiple sex partners in the past 12 months (AOR = 2.3, CI [1.0, 5.1], p = 0.0491), but no more likely to know where to get HIV testing or to have ever been tested. Victims of childhood sexual violence could benefit from targeted interventions to mitigate impacts of violence and prevent HIV.

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Editor’s notes: A growing body of evidence has established an association between sexual violence and increased vulnerability to HIV infection. Childhood sexual violence may increase HIV risk both directly (e.g. forced sex) and indirectly (e.g. through high-risk sex behaviours later in life). This paper examined two questions: is childhood violence exposure associated with (i) high-risk sexual behaviour in early adulthood and (ii) increased/decreased knowledge and uptake of HIV testing services.

A nationally representative sample of females aged 19-24 years were surveyed. Women were excluded from the analyses if they were not sexually active. Some 26.1% of 579 women reported childhood sexual violence (answering yes to one of four questions around unwanted touch / attempted rape / unwanted / coercive sexual intercourse before age 18 years). Childhood sexual violence was associated with (i) low / no condom use with someone other than husband / live in partner and (ii) >1 sexual partner, past 12 months. There was no association with knowledge or uptake of HIV testing services. These findings are consistent with research done elsewhere and suggest childhood sexual violence is associated with increased sexual risk taking behaviours in early adulthood. These findings present evidence for the importance of programmes to reduce childhood exposure to violence and focussed, adolescent-friendly sexual health services.

Africa
United Republic of Tanzania
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