Coerced and forced sexual initiation and its association with negative health outcomes among youth: Results from the Nigeria,Uganda, and Zambia Violence Against Children Surveys |
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| Institution: | 1. Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA;2. Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;3. Nigeria Country Office, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria;4. Uganda Country Office, Center for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda;5. Zambia Country Office, Center for Global Health, Centers for Disease Control and Prevention, Lukasa, Zambia;1. Doha Institute for Graduate Studies, Al Tarfa Street, Zone 70, PO Box 200592, Al-Daayen, Qatar;2. Institute of Community and Public Health, Birzeit University, PO Box 14, Birzeit, Palestine;1. Cook Children’s Medical Center, Fort Worth, TX, United States;2. Texas A&M University College of Medicine, Bryan, TX, United States;1. Contractor for Certified Technical Experts, Division of Violence Prevention, National Center for Injury Control and Prevention, Atlanta, GA, USA;2. Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA;3. Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;4. Ministry of Gender, Children and Social Welfare, Malawi;1. London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK;2. Raising Voices, Plot 16 Tufnell Drive, Kampala, Uganda;3. Makerere University, Kampala, Uganda |
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| Abstract: | IntroductionCoerced and forced sexual initiation (FSI) can have detrimental effects on children and youth. Understanding health outcomes that are associated with experiences of FSI is important for developing appropriate strategies for prevention and treatment of FSI and its consequences.MethodsThe Violence Against Children Surveys were conducted in Nigeria, Uganda, and Zambia in 2014 and 2015. We examined the prevalence of FSI and its consequences (sexual high-risk behaviors, violence experiences, mental health outcomes, and sexually transmitted infections (STI)) associated with FSI among youth aged 13–24 years in three countries in sub-Saharan Africa.ResultsOver one in ten youth aged 13–24 years who had ever had sex experienced FSI in Nigeria, Uganda, and Zambia. In multivariable logistic regression, FSI was significantly associated with infrequent condom use (OR = 1.4, 95%CI = 1.1–2.1), recent experiences of sexual violence (OR = 1.6, 95%CI: 1.1–2.3), physical violence (OR = 2.2, 95%CI: 1.6–3.0), and emotional violence (OR = 2.0, 95%CI: 1.3–2.9), moderate/serious mental distress (OR = 1.5, 95%CI: 1.1–2.0), hurting oneself (OR = 2.0, 95%CI: 1.3–3.1), and thoughts of suicide (OR = 1.5, 95%CI: 1.1–2.3), after controlling for demographic characteristics. FSI was not statistically associated with engaging in transactional sex, having multiple sex partners, or having a STI.ConclusionFSI is associated with infrequent condom use, recent experiences of violence and mental health outcomes among youth in sub-Saharan Africa, which may increase the risk for HIV and other consequences. Developing strategies for prevention is important for reducing the prevalence of FSI and its effects on children and youth. |
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| Keywords: | Sexual violence Coerced and forced sex Forced sexual initiation Childhood violence Risk-taking behaviors |
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