Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC)

Association between lifetime sexual violence victimization and selected health conditions and risk behaviors among 13-24-year-olds in Lesotho: Results from the Violence Against Children and Youth Survey (VACS), 2018

BACKGROUND

Sexual violence is a serious public health concern worldwide. In Lesotho, one in seven women and one in twenty men aged 18 years and older experienced sexual violence during childhood. Sexual violence victimization may lead to long-term mental and physical health issues among victims, regardless of gender.

OBJECTIVE

To estimate the prevalence of lifetime sexual violence victimization (SV) among 13-24-year-olds in Lesotho and assess its association with selected health conditions and risk behaviors.

PARTICIPANTS AND SETTING

Data from 13 to 24-year-old participants (n = 8568) of the 2018 Lesotho Violence Against Children and Youth Survey were analyzed.

METHODS

SV was defined as reporting one or more types of sexual violence at any age. Logistic regression analyses measured associations between SV and selected health conditions (suicidal thoughts, self-harm behaviors, mental distress, STIs, and HIV), and risk behaviors (binge drinking in the past 30 days, drug use in the past 30 days, infrequent condom use in the past 12 months, multiple sex partners in the past 12 months, and transactional sex in the past 12 months).

RESULTS

After controlling for study covariates, SV was significantly associated with self-harm behaviors, suicidal thoughts, ever having an STI, binge drinking in the past 30 days, infrequent condom use in the past 12 months, and multiple sex partners in the past 12 months for both males and females; and mental distress and transactional sex in the past 12 months for females.

CONCLUSIONS

Preventing SV against children and youth in Lesotho may improve their health and wellbeing.

Prevalence and Risk Factors Associated With Physical and/or Sexual Abuse Among Female Middle School Students: A Cross- Sectional Study in Kinshasa, DRC

This cross-sectional study sought to broaden the limited evidence on violence against young adolescent girls in non-conflict zones within the Democratic Republic of the Congo (DRC). Our goal was to estimate the prevalence of and the predictors of physical and/or sexual abuse among girls aged 11-18 years in Kinshasa. A total of 3,100 girls from five randomly selected schools were recruited by our team and given the questionnaires; among them, 3,011 (97.1%) participants completed the questionnaires and were included in the study for further analysis. After collecting all valid responses, the overall prevalence of physical and/or sexual abuse was sorted into the following categories: experienced physical abuse without a weapon (recorded by 70.1% of respondents), experienced physical abuse with a weapon (66.3% of respondents), attempted rape without penetration (76.5% of respondents), experienced attempted rape with penetration (73.9% of respondents), and experienced verbal sexual harassment (93.0%).Our logistic regression analysis indicated that specific kinds of living arrangements (such as only living with the father, mother, or a caregiver; odds ratio ranged 1.8 to 6.9) and places of residence (such as living in lower-class or middle-class districts; odds ratio ranged 1.7 to 6.2) had the strongest associations with higher risk pertaining to whether the respondent had experienced physical and/or sexual abuse in the past. Meanwhile, factors such as the students' level of education (both middle grade and upper grade) and occupation of the father (specifically whether holding a part-time job or retired) were deemed to be more protective. However, physical and/or sexual abuse prevalence was found to be high among middle school girls in Kinshasa. Therefore, we recommend that drastic policies and strategies aimed at socioeconomic issue and living condition ameliorations among families should be implemented to curtail physical and sexual abuse in the nonconflict zones of the DRC.

Nonverbal Response Cards Reduce Socially Desirable Reporting of Violence Among Adolescents in Rural Burkina Faso: A Randomized Controlled Trial

PURPOSE

Accurate measures of violence are difficult to obtain from self-reported data because of stigmatization and social undesirability of the topic. Most methods that attempt to reduce such biases require literacy and either remove the benefits of interviewer guidance or do not give individual-level results. We tested a low-tech nonverbal response card that avoids revealing interviewees' responses to interviewers while retaining interviewer support among adolescents in communities with very low educational attainment.

METHODS

As part of a broader health questionnaire, we asked a sample of 1,644 adolescents, aged 12-20 years, in northwestern Burkina Faso about their experiences of physical and sexual violence. We randomized participants to either a conventional verbal response arm or a nonverbal response card arm where respondents' answers were unspoken and not displayed to interviewers. We first evaluated response validity and reliability in each arm, then compared prevalence rates across arms and evaluated whether any differences varied by respondent characteristics using regression models.

RESULTS

The level of internal reliability of responses among nonverbal respondents was similar to or greater than that of verbal respondents. Nonverbal respondents reported similar patterns of physical assault and sexual debut as verbal respondents but significantly higher levels of sexual assault and forced sex. These differences were broadly similar across sample subgroups defined by age, gender, proneness to social desirability, and mental health.

CONCLUSIONS

Nonverbal response cards offer a practical and beneficial method for reducing underreporting of stigmatized and traumatic experiences while maintaining data quality in low-literacy populations.

Sexual and Gender-Based Violence Among Refugees and Internally Displaced Persons in the Democratic Republic of the Congo: Post-Conflict Scenario

The ongoing humanitarian crisis in the Democratic Republic of the Congo has triggered sexual and gender-based violence, including rape, sexual slavery, trafficking, intimate partner violence, and sexual exploitation. Gender inequalities and abuse of power experienced by women and young girls at refugee settings further exacerbate their vulnerability to different forms of violence. This study aimed to offer an evidence-based approach to developing strategies in tackling the complex problem of sexual and gender-based violence among refugees and internally displaced persons in the Congo. We conducted a narrative review of all the relevant papers known to the authors to explore the origins of the problem, its implications on public health, and its impact on equity. The study revealed that sexual assault survivors face physical and psychological sufferings, excruciating emotions, and profound disruption of their social well-being since they are often stigmatized and ostracized by society. The analysis of current government policies revealed a lack of programs to address survivors' specific concerns and policy enforcement problems. This study suggested strategic objectives and policy implementation steps. The proposed strategies address women empowerment and gender stigma, provision of effective health services, and adequate response action.