TY  - JOUR
PY  - 2023//
TI  - Adverse childhood experiences, HIV and sexual risk behaviors - five sub-Saharan countries, 2018-2020
JO  - Child abuse and neglect
A1  - Kanagasabai, Udhayashankar
A1  - Thorsen, Viva
A1  - Zhu, Liping
A1  - Annor, Francis B.
A1  - Chiang, Laura
A1  - McOwen, Jordan
A1  - Augusto, Angelo
A1  - Manuel, Pedro
A1  - Kambona, Caroline
A1  - Coomer, Rachel
A1  - Kamagate, Fathim
A1  - Ramphalla, Puleng
A1  - Denhard, Langan
A1  - Cain, Meagan
A1  - Hegle, Jennifer
A1  - de Barros, Regina Benevides
A1  - Saenz, Shantal
A1  - Kamami, Mwikali
A1  - Patel, Pragna
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Adverse childhood experiences (ACEs) have been shown to have negative, lasting effects on health including increasing the likelihood of engaging in sexual risk behaviors. <br><br>OBJECTIVE: This study aimed to identify associations between exposures to ACEs and sexual risk behaviors and HIV service utilization among young people. PARTICIPANTS AND SETTING: A sample of 8023 sexually active young people (19-24 year olds) from five sub-Saharan African countries participated Violence Against Children and Youth Surveys (VACS). <br><br>METHODS: Descriptive analysis of demographic variables, individual ACEs, cumulative ACEs, sexual risk behaviors, HIV testing, antiretroviral treatment (ART) and Antenatal Care (ANC) attendance were completed. Bivariate and multivariable logistic regression analyses were conducted to assess the associations between both individual and cumulative ACEs, sexual HIV risk behaviors, and service utilization while controlling for important covariates such as demographic, having ever been pregnant, had an STI, and used contraception. <br><br>RESULTS: Exposure to three or more ACEs was higher among males (26.1 %) compared to females (21.3 %); p = 0.003. The most prominent sexual risk behavior for females was having sexual partners who were at least 5 years older (45.7 % compared to males 3.7 %; p < 0.0001) whereas in males it was no or infrequent condom use (45.3 % compared to females 30.1 %; p < 0.0001). Males and females exposed to childhood sexual violence had seven and four times the odds of engaging in transactional sex (aOR = 7.34, 95 % CI: [3.5-15.0]) and (aOR =3.75, 95 % CI: [2.3-6.2], respectively. Females exposed to three or more ACEs were four times more likely to engage in transactional sex (aOR = 4.85, 95 %, CI: [1.6-14.4]) compared to those who did not experience any ACEs. Males exposed to three or more ACEs were two times more likely to engage in early sexual debut (aOR = 2.2, 95 % CI: [1.3-3.4]),]) compared to those who did not experience any ACEs. Females who had witnessed IPV or violence in the community had significantly higher odds of getting tested for HIV (aOR = 2.16, 95 % CI: [1.63-2.87]) and (aOR = 1.36, 95 % CI: [1.03-1.81]), respectively. <br><br>CONCLUSIONS: This study demonstrated that experiencing ACEs during childhood is associated with higher HIV risk behaviors in sub-Saharan Africa (SSA) with unique differences between males and females.<p />  <p>Language: en</p>
LA  - en
SN  - 0145-2134
UR  - http://dx.doi.org/10.1016/j.chiabu.2023.106541
ID  - ref1
ER  -