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Reported Physical and Sexual Abuse in Childhood and Adult HIV Risk Behaviour in Three African Countries: Findings from Project Accept (HPTN-043)

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Abstract

Childhood sexual and physical abuse have been linked to adolescent and adult risky sexual behaviors, including early sexual debut, an increased number of sexual partners, unprotected sex, alcohol and drug use during sex and sexual violence. This paper explores these relationships among both men and women who report histories of childhood abuse from representative samples of communities in three countries in southern and eastern Africa (South Africa, Zimbabwe and Tanzania). Data were collected as part of a 3-year randomized community trial to rapidly increase knowledge of HIV status and to promote community responses through mobilisation, mobile testing, provision of same-day HIV test results and post-test support for HIV. The results indicate that reported childhood sexual and physical abuse is high in all three settings, also among men, and shows strong relationships with a range of sexual risk behaviors, including age at first sex (OR −0.6 (CI: −0.9, −0.4, p < 0.003)—among men, OR −0.7 (CI: −0.9, −0.5, p < 0.001)—among women), alcohol (OR 1.43 (CI: 1.22, 1.68, p < 0.001)—men, OR 1.83 (CI: 1.50, 2.24, p < 0.001)—women) and drug use (OR 1.65 (CI: 1.38, 1.97, p < 0.001)—men, OR 3.14 (CI: 1.95, 5.05, p < 0.001)—women) and two forms of partner violence—recent forced sex (OR 2.22 (CI: 1.66, 2.95, p < 0.001)—men, OR 2.76 (CI: 2.09, 3.64, p < 0.001)—women) and ever being hurt by a partner (OR 3.88 (CI: 2.84, 5.29, p < 0.001)—men, OR 3.06 (CI: 2.48, 3.76, p < 0.001)—women). Individuals abused in childhood comprise between 6 and 29 % of young adult men and women living in these African settings and constitute a population at high risk of HIV infection.

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Acknowledgments

The research was sponsored by the U.S. National Institute of Mental Health as a cooperative agreement, through contracts U01MH066687 (Johns Hopkins University), U01MH066688 (Medical University of South Carolina), U01MH066701 (University of California, Los Angeles), and U01MH066702 (University of California, San Francisco). In addition, this work was supported by the HIV Prevention Trials Network (HPTN Protocol 043) of the Division of AIDS of the U.S. National Institute of Allergy and Infectious Diseases, and by the Office of AIDS Research of the U.S. National Institutes of Health. Views expressed are those of the authors, and not necessarily those of sponsoring agencies. We thank the communities that partnered with us in conducting this research, and all study participants for their contributions. We also thank study staff and volunteers at all participating institutions for their contribution to the project.

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Authors and Affiliations

  1. HIV/AIDS, STIs and TB Programme, Human Sciences Research Council, 750 Francois Road, Durban, 4001, South Africa

    Linda Richter & Chris Desmond

  2. Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa

    Linda Richter & Chris Desmond

  3. Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic

    Arnošt Komárek

  4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    David Celentano

  5. Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, CA, USA

    Steve Morin

  6. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA

    Michael Sweat

  7. Research Institute for Health Sciences and Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Suwat Chariyalertsak

  8. Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe

    Alfred Chingono

  9. Perinatal HIV Research Unit, University of the Witswatersrand, Johannesburg, South Africa

    Glenda Gray

  10. Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

    Jessie Mbwambo

  11. Department of Medicine, University of California, Los Angeles, CA, USA

    Tom Coates

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  1. Linda Richter
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Correspondence to Linda Richter.

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Richter, L., Komárek, A., Desmond, C. et al. Reported Physical and Sexual Abuse in Childhood and Adult HIV Risk Behaviour in Three African Countries: Findings from Project Accept (HPTN-043). AIDS Behav 18, 381–389 (2014). https://doi.org/10.1007/s10461-013-0439-7

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  • DOI: https://doi.org/10.1007/s10461-013-0439-7

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