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Mukanga B, Dlamini SB, Mwanabute N, Taylor M. Adolescents' risky sexual behaviours and practices: Implications for sexuality education implementation in Zambia. Afr J Prim Health Care Fam Med 2024; 16:e1-e11. [PMID: 39099271 PMCID: PMC11304187 DOI: 10.4102/phcfm.v16i1.4476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Adolescents' risky sexual behaviours (RSB) are detrimental to their sexual and reproductive health (SRH) well-being and present a serious public health threat, particularly in low- and middle-income countries (LMICs). AIM This study aims to assess RSB among Grade 12 school-going adolescents after exposure to comprehensive sexuality education (CSE). SETTING This study was conducted in Kitwe district, Zambia. METHODS This cross-sectional study included 807 Grade 12 pupils at 13 selected secondary schools. Data were collected using a structured questionnaire. Proportionate probability sampling involving 13 schools was employed. Risky sexual behaviours binary outcome variables were based on transactional sex, sex while drunk, multiple sexual partners, age-disparate sexual relationships, and condomless sex. We conducted univariate and bivariate analyses to summarise sociodemographic factors and fitted binary and multivariable logistic regression models. RESULTS The prevalence of RSB was 40.4%. Drinking alcohol (adjusted odds ratio [AOR] = 20.825; 95% CI [6.7-64.489]); ever had sex (AOR = 9.024; 95% CI [1.953-41.704]); school location (AOR = 6.50; 95% CI [1.61-26.24]); living with mother only (AOR = 4.820; 95% CI [1.328-17.493]); sex (male) (AOR = 2.632; 95% CI [1.469-4.713]), watching pornography (AOR = 1.745; 95% CI [1008-3.021]); religion (AOR = 0.472; 95% CI [0.250-0.891]) and attending religious functions (AOR = 0.317; 95% CI [0.118-0.848]) were significantly associated with RSB. Of the sexually active pupils, 221 (67.7%), 64 (19.6%) and 41 (12.5%) were in the low, medium and high-risk categories, respectively. CONCLUSION Close to half of the respondents engaged in RSB. This is a significant number that needs intervention. The CSE programme needs to be linked with structural programmes that address the social drivers of RSB among adolescents.Contribution: The study provides a backdrop for evaluating current CSE strategies in LMICs.
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Affiliation(s)
- Bright Mukanga
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; and Department of Public Health, School of Medicine, Copperbelt University, Ndola.
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Kaur A, Brown MJ, James TA, Nkwonta CA, Hart MJ. Stories of childhood sexual abuse (CSA) among older adults living with HIV (OALH) in South Carolina: a qualitative study. AIDS Care 2024; 36:272-279. [PMID: 37139537 PMCID: PMC10622329 DOI: 10.1080/09540121.2023.2208323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/24/2023] [Indexed: 05/05/2023]
Abstract
Childhood sexual abuse (CSA) devastatingly impacts an individual's behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, "nobody believed me", "cannot live like others", lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors.
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Affiliation(s)
- Amandeep Kaur
- Department of Biostatistics and Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208
| | - Monique J. Brown
- Department of Biostatistics and Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Titilayo A. James
- Department of Biostatistics and Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208
| | | | - Mackenzie J. Hart
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC
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Fu G, Xu Y, Pan M, Zhang Z, Zhang H, Zhao Y, Lin L, Ye Z, Liu J, Lan F, Luo D, Wang S, Zhu B, Liao X, Hong M, Chen J, Li Z, Yang G, Zhao Z, Liu Y, Ruan F, Yang C, Wang J. Ecological factors associated with child sexual abuse among 15- to 17-year-old adolescents in mainland China: implications for intervention. Front Public Health 2023; 11:1169669. [PMID: 37927859 PMCID: PMC10623125 DOI: 10.3389/fpubh.2023.1169669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Background Child sexual abuse is a major public health problem with adverse consequences for victims' physical, mental, and reproductive health. This cross-sectional study aimed to determine the prevalence of child sexual abuse and its associated factors among 15- to 17-year-old adolescents in mainland China. Methods From September 8, 2019 to January 17, 2020, a total of 48,660 participants were recruited by 58 colleges and universities across the whole country to complete the self-administered, structured, online questionnaire. This analysis was restricted to 3,215 adolescents aged between 15 and 17 years in mainland China. Chi-square tests and multivariate Logistic regression analyses were performed to identify individual, relationship, and community factors associated with child sexual abuse. Results The overall prevalence of child sexual abuse was 12.0%. More specifically, 13.0% of girls and 10.6% of boys reported that they were sexually abused prior to 18 years of age. At the individual level, being female, sexual minority identity, younger age, and higher levels of knowledge, skills and self-efficacy regarding condom use were significantly related to increased odds of reporting sexual abuse. At the relationship and community level, adolescents from disrupted families and those entering into a marriage, having casual sexual partners, and having first intercourse at a younger age were more likely to report sexual abuse. On the contrary, those who had never discussed sex-related topics with their family members at home and were offered school-based sexuality education later (vs. earlier) were less likely to report sexual abuse. Conclusion Multilevel prevention programs and strategies, including targeting adolescents with high-risk characteristics, educating young children and their parents about child sexual abuse prevention and optimizing the involvement of parents, school, community, society and government in comprehensive sexuality education, should be taken to reduce child sexual abuse among 15- to 17-year-old adolescents.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chunyan Yang
- Department of Preventive Medicine, Hubei University of Science and Technology, Xianning, China
| | - Junfang Wang
- Department of Preventive Medicine, Hubei University of Science and Technology, Xianning, China
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Tenkorang EY. Physical, sexual, and psychosocial health impacts of child abuse: Evidence from Ghana. ADVANCES IN LIFE COURSE RESEARCH 2023; 57:100559. [PMID: 38054860 DOI: 10.1016/j.alcr.2023.100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/24/2023] [Accepted: 06/04/2023] [Indexed: 12/07/2023]
Abstract
Child abuse is a significant global health problem. While data on child abuse in Ghana are scant, anecdotal evidence suggests the vast majority of Ghanaian children have experienced some form of physical or sexual abuse. This paper explores links between early childhood abuse and health outcomes using a life course perspective. Nationally representative cross-sectional data were collected from a sample of 2289 ever-married Ghanaian women in 2017. Women provided retrospective accounts of different types of violence in early childhood. Random-effects logit models were used to examine the impact of two dimensions of early childhood abuse (physical and sexual) on the physical, sexual, and psychosocial health outcomes of women in later years. Women who experienced childhood physical abuse, but not often, were significantly more likely to report physical disabilities in later years than women who did not experience it. Women reporting childhood sexual abuse were more likely to be depressed in later years than those who never experienced such abuse. They were also significantly more likely to report sexually transmitted diseases. Our findings provide support for the life course theory by showing abuse experienced in childhood could have a long-term impact. We therefore suggest the need for early interventions to address child abuse.
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Affiliation(s)
- Eric Y Tenkorang
- Department of Sociology, Memorial University, St. John's, NL A1C 5S7, Canada.
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Howard AL, Chiang L, Picchetti V, Zhu L, Hegle J, Patel P, Saul J, Wasula L, Nantume S, Coomer R, Kamuingona R, Oluoch RP, Mharadze T, Duffy M, Kambona CA, Ramphalla P, Fathim KM, Massetti GM. Population Estimates of HIV Risk Factors to Inform HIV Prevention Programming for Adolescent Girls and Young Women. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:20-38. [PMID: 37406147 PMCID: PMC11249023 DOI: 10.1521/aeap.2023.35.suppa.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Violence Against Children and Youth Survey (VACS) data from seven countries were analyzed to estimate population-level eligibility for the President's Emergency Plan for AIDS Relief (PEPFAR) Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) HIV prevention program for adolescent girls and young women (AGYW). The prevalence of overall eligibility and individual risk factors, including experiences of violence, social, and behavioral risks differ across countries and age groups. A large proportion of AGYW across all countries and age groups examined have at least one risk factor making them eligible for DREAMS. Experiencing multiple risks is also common, suggesting that researchers and programs could work together to identify combinations of risk factors that put AGYW at greatest risk of HIV acquisition, or that explain most new HIV infections, to more precisely target the most vulnerable AGYW. The VACS provides important data for such analyses to refine DREAMS and other youth programming.
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Affiliation(s)
- Ashleigh L Howard
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Laura Chiang
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Viani Picchetti
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Liping Zhu
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Jennifer Hegle
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Pragna Patel
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Janet Saul
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Lydia Wasula
- Uganda Ministry of Gender, Labor and Social Development, Kampala, Uganda
| | | | | | - Rahimisa Kamuingona
- Namibia Ministry of Gender Equality, Poverty Eradication and Social Services, Windhoek, Namibia
| | | | | | | | | | - Puleng Ramphalla
- CDC, Lesotho Country Office, Maseru, Lesotho. Puleng Ramphalla, MS, is affiliated with the CDC, Côte d'Ivoire Country Office, Abidjan, Côte d'Ivoire
| | | | - Greta M Massetti
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
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Kidman R, Breton E, Behrman J, Kohler HP. A prospective study on adverse childhood experiences and HIV-related risk among adolescents in Malawi. AIDS 2022; 36:2181-2189. [PMID: 36083145 PMCID: PMC9671836 DOI: 10.1097/qad.0000000000003377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Adverse childhood experiences have been robustly associated with poor sexual health in later life. In low-income countries, there is growing evidence that children experience greater adversity than those in higher income countries. Research suggests this may contribute to later sexual risk taking and HIV infection, though most studies to date have been cross-sectional. DESIGN We use longitudinal data on adolescents to examine the temporal relationship between adversity and HIV-related behavioral and biological outcomes. METHODS We interviewed 1878 adolescents living in Malawi in 2017-2018 (age 10-16) and again in 2021 (age 13-20). Adolescents completed the Adverse Childhood Experience - International Questionnaire. HIV-risk was assessed through both behavioral (e.g. condom use) and biological (HIV and herpes simplex virus 2 [HSV2] infection) outcomes. ordinary least squares (OLS) and logistic multivariate regression models are used to explore associations between adversity and HIV risk. RESULTS In longitudinal analyses, adverse childhood experiences (ACEs) were significantly associated with intimate partner violence and girls' behavioral risk scores only. HIV incidence was too low to model; there were no significant associations with HSV2. In cross-sectional analyses, ACEs were additionally associated with an early sexual debut, lack of condom use, a greater number of sexual partnerships, and sexually transmitted infection symptoms. CONCLUSIONS Our findings emphasize the importance of collecting prospective data: results from longitudinal and cross-sectional analyses drew qualitatively different conclusions. Cross-sectional analyses may not be accurate representations of longitudinal processes. However, they suggest that recent adversity and distress drives HIV-related behavior, perhaps more than early adversity. Interventions that combat emotional abuse or peer violence during adolescence could potentially reduce HIV risk.
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Affiliation(s)
- Rachel Kidman
- Program in Public Health and Department of Family, Population and Preventive Medicine Stony Brook University (State University of New York), Stony Brook, New York
| | | | - Jere Behrman
- Departments of Economics and Sociology, Population Aging Research Center and Population Studies Center
| | - Hans-Peter Kohler
- Department of Sociology, Population Aging Research Center and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Parchure R, Darak S, Darak T, Kulkarni V. Mapping HIV risk trajectories from adolescence to young adulthood: a life-course study among unmarried urban Indian youth. AIDS Care 2022; 34:1118-1126. [PMID: 34612095 DOI: 10.1080/09540121.2021.1985718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The study explores trajectories of HIV risks from adolescence to adulthood among unmarried, educated (12+ years of formal education), 20-29 year old youth. Retrospective time event data (n=517) was used to build HIV risk trajectories (age 10 onwards), employing group-based trajectory technique and multinomial logistic regression in SAS v9.4. Among men (n=271), 10% had "Declining risk - high to low", and 15% had "consistent high risk". Among women (n=246), 11% had "late-rising risk", and 15% had "consistent high risk". Among women, childhood experience of sexual abuse, having self-income, father education until 12th standard, frequent alcohol use predicted higher risk trajectories. Among men, it was an early sexual debut, alcohol dependency in parent/s, non-heterosexual orientation, early sexual debut, and frequent alcohol use. The HIV risk behaviors of unmarried Indian youth are diverse. A subsection engages in high-risk behaviors that change over time and have linkages to developmental factors.
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Kamukama A, Luwaga R, Tugume R, Kanyemibwa M, Birungi B, Ndyamuhika O, Ampire D, Nduhukire T, Shindell DL. Exploring parental understanding of child sexual abuse and prevention as a measure for HIV prevention in Rwampara district. PLoS One 2022; 17:e0269786. [PMID: 35771803 PMCID: PMC9246133 DOI: 10.1371/journal.pone.0269786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 05/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background Worldwide, more than 95 million children are sexually abused each year with children in sub-Saharan Africa experiencing sexual assault at higher rates than those in more developed areas. In Uganda, 20% of young people indicated that their sexual debut was non-consensual. The risk for transmission of HIV to children through Child Sexual Abuse is high because of greater mucosal tissue damage and the often repetitive nature of abuse. This contributes significantly to the burden of HIV in Uganda. Despite these risks, studies have shown gaps in active parental involvement in child sexual abuse prevention despite their being the primary protectors of children. Against this background we sought to explore parental understanding of childhood sexual abuse and prevention as a measure for HIV prevention in Rwampara District, South Western Uganda. Methods A phenomenological study was carried out in four health centers that serve the communities of Rwampara district. A total of 25 (n = 25) parents or guardians of children aged 9–14 years were purposively selected to participate in the study. The participants were subjected to in-depth semi-structured interviews which were recorded, transcribed, and translated for thematic analysis. Results Parents’ understanding of child sexual abuse was limited to penetrative sex between a man and a child. Three of the parents interviewed reported to have had children who had been sexually abused while one of the parents had been abused when she was young. The children reported to have been abused were female and were between 3-14years. We also identified gaps in the sensitization of parents regarding home-based prevention of child sexual abuse and psychological support for the victims of abuse. Conclusion Our study shows that child sexual abuse exists in rural western Uganda. There remains a significant gap in the awareness of parents regarding the extent of sexual abuse, signs of sexual abuse, case handling, and psychological support for victims of sexual abuse. This significantly affects the capacity of parents as the primary protectors of children to identify and protect the children against the multiple forms of child sexual abuse.
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Affiliation(s)
| | - Rachel Luwaga
- Department of Nursing, Bishop Stuart University, Mbarara, Uganda
- * E-mail:
| | - Rodrick Tugume
- Department of Nursing, Bishop Stuart University, Mbarara, Uganda
| | | | - Betrace Birungi
- Department of Nursing, Bishop Stuart University, Mbarara, Uganda
| | - Obed Ndyamuhika
- Department of Nursing, Bishop Stuart University, Mbarara, Uganda
| | - Diana Ampire
- Department of Nursing, Bishop Stuart University, Mbarara, Uganda
| | - Timothy Nduhukire
- Department of Pediatrics and Child Health, Kabale University, Kabale, Uganda
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Naicker SN, Ahun MN, Besharati S, Norris SA, Orri M, Richter LM. The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1799. [PMID: 35162821 PMCID: PMC8835353 DOI: 10.3390/ijerph19031799] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 02/01/2023]
Abstract
Human capital-that is the cumulative abilities, education, social skills, and mental and physical health one possesses-is increasingly recognized as key to the reduction of inequality in societies. Adverse childhood experiences have been linked to a range of human capital indicators, with the majority of research in high-income, western settings. This study aims to examine the link between adverse childhood experiences and adult human capital in a South African birth cohort and to test whether associations differ by measurement of adversity. Secondary analysis of data from the Birth to Thirty study was undertaken. Exposure data on adversity was collected prospectively throughout childhood and retrospectively at age 22. Human capital outcomes were collected at age 28. Adversity was measured as single adverse experiences, cumulative adversity, and clustered adversity. All three measurements of adversity were linked to poor human capital outcomes, with risk for poor human capital increasing with the accumulation of adversity. Adversity was clustered by quantity (low versus high) and type (household dysfunction versus abuse). Adversity in childhood was linked to a broad range of negative outcomes in young adulthood regardless of how it was measured. Nevertheless, issues of measurement are important to understand the risk mechanisms that underlie the association between adversity and poor human capital.
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Affiliation(s)
- Sara N. Naicker
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg 2050, South Africa; (S.A.N.); (L.M.R.)
| | - Marilyn N. Ahun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- School of Public Health, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Sahba Besharati
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg 2050, South Africa;
- CIFAR Azrieli Global Scholars Program, CIFAR, Toronto, ON M5G 1M1, Canada
| | - Shane A. Norris
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg 2050, South Africa; (S.A.N.); (L.M.R.)
- SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg 2050, South Africa
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Linda M. Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg 2050, South Africa; (S.A.N.); (L.M.R.)
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Logie CH, Toccalino D, Reed AC, Malama K, Newman PA, Weiser S, Harris O, Berry I, Adedimeji A. Exploring linkages between climate change and sexual health: a scoping review protocol. BMJ Open 2021; 11:e054720. [PMID: 34663670 PMCID: PMC8524293 DOI: 10.1136/bmjopen-2021-054720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION The effects of climate change and associated extreme weather events (EWEs) present substantial threats to well-being. EWEs hold the potential to harm sexual health through pathways including elevated exposure to HIV and other sexually transmitted infections (STIs), disrupted healthcare access, and increased sexual and gender-based violence (SGBV). The WHO defines four components of sexual health: comprehensive sexuality education; HIV and STI prevention and care; SGBV prevention and care; and psychosexual counselling. Yet, knowledge gaps remain regarding climate change and its associations with these sexual health domains. This scoping review will therefore explore the linkages between climate change and sexual health. METHODS AND ANALYSIS Five electronic databases (MEDLINE, EMBASE, PsycINFO, Web of Science, CINAHL) will be searched using text words and subject headings (eg, Medical Subject Headings (MeSH), Emtree) related to sexual health and climate change from the inception of each database to May 2021. Grey literature and unpublished reports will be searched using a comprehensive search strategy, including from the WHO, World Bank eLibrary, and the Centers for Disease Control and Prevention. The scoping review will consider studies that explore: (a) climate change and EWEs including droughts, heat waves, wildfires, dust storms, hurricanes, flooding rains, coastal flooding and storm surges; alongside (b) sexual health, including: comprehensive sexual health education, sexual health counselling, and HIV/STI acquisition, prevention and/or care, and/or SGBV, including intimate partner violence, sexual assault and rape. Searches will not be limited by language, publication year or geographical location. We will consider quantitative, qualitative, mixed-methods and review articles for inclusion. We will conduct thematic analysis of findings. Data will be presented in narrative and tabular forms. ETHICS AND DISSEMINATION There are no formal ethics requirements as we are not collecting primary data. Results will be published in a peer-reviewed journal and shared at international conferences.
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Affiliation(s)
- Carmen H Logie
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Danielle Toccalino
- Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada
| | - Anna Cooper Reed
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Sheri Weiser
- Department of Medicine, University of California, San Francisco, California, USA
| | - Orlando Harris
- Department of Community Health Systems, University of California, San Francisco, California, USA
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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Al-Saadoon M, Al-Adawi M, Al-Adawi S. Socio-Cultural Constraints in Protecting Child Rights in a Society in Transition: A Review and Synthesis from Oman. CHILD INDICATORS RESEARCH 2021; 14:239-267. [PMID: 32837628 PMCID: PMC7412292 DOI: 10.1007/s12187-020-09759-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/21/2020] [Indexed: 05/18/2023]
Abstract
In line with international best practice, the Arabian Gulf countries have ratified the Convention on the Right of the Child (CRC), which has some clauses on child abuse and neglect. The present discourse, made from within an Arabian Gulf society, specifically Oman, reviews the socio-cultural differences of the region and explores the potential regional challenges for effectively implementing the CRC mandated child protection legislation. The international best practices evolved for individualistic, "guilt-based" societies, which may need to be modified to suit the "shame-based" collective societies in the Arabian Gulf where the individual autonomy is overridden by that of the family and society. This may mean that the entire spectrum of child abuse may need to be studied in-depth, starting from what constitutes child abuse and neglect, the methods adopted for identifying cases, setting preventive measures in place, applying penal and corrective action on the perpetrators, and helping the victims recover. It is posited that while modifying the laws may be straightforward, implementation of certain clauses may initially come into conflict with deeply engrained socio-cultural conventions on these societies which have different parenting styles and child-rearing practices. The country in focus is Oman. Pointing out the sparsity of research on the topic in the region, the study suggests additional research to understand how to reconcile these sociocultural constraints with the international best practices of protecting child rights.
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Affiliation(s)
- Muna Al-Saadoon
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Manal Al-Adawi
- Department of Behavioural Science & Psychiatry, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khoudh, 123 Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioural Science & Psychiatry, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khoudh, 123 Muscat, Oman
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12
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McCloskey LA, Eloff I, Doran K. Determinants of intergenerational sexual relationships and HIV risk among South African women outpatients in Gauteng. AIDS Care 2020; 33:654-662. [PMID: 32964726 DOI: 10.1080/09540121.2020.1823311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Age-discrepant sexual relationships may place women at risk for HIV infection in South Africa. Results are based on medical records and case-control interview data of 889 sexually experienced women outpatients aged 15-29 in a Gauteng township. Women with partners at least ten years older (intergenerational) show an elevated chance of having an early sexual debut, concurrent and transactional partners, and intimate partner violence. Hardship during childhood including parental loss, food insecurity and abuse are related to age asymmetric relationships. HIV is two times more likely (aOR=1.96) with an intergenerational partner. Transactional sex increases the odds of HIV independently (aOR=1.76) as does intimate partner violence (aOR=1.6). To the extent that transactional and intergenerational sex overlap the chance of contracting HIV increases more than two-fold (uOR=4.57). Girls (15-19) with intergenerational partners face the highest chance of HIV (uOR=8.55) compared to other age groups. They are also five times more likely than controls to have lived with a cross-age partner. Our findings indicate there are multiple pathways emanating from childhood leading to women's choice of intergenerational partners, and the link to HIV is strongest among the youngest women.
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Affiliation(s)
- Laura Ann McCloskey
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Irma Eloff
- Department of Educational Psychology, University of Pretoria School of Education, Pretoria, South Africa
| | - Kelly Doran
- UNH Institute on Disability, College of Health and Human Services, University of New Hampshire, Durham, NH, USA
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Kabapy AF, Shatat HZ, Abd El-Wahab EW. Attributes of HIV infection over decades (1982-2018): A systematic review and meta-analysis. Transbound Emerg Dis 2020; 67:2372-2388. [PMID: 32396689 DOI: 10.1111/tbed.13621] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 01/19/2023]
Abstract
Understanding the risk factors for HIV infection is the foundation of successful preventive strategies, which must bundle sociocultural, behavioural and biomedical interventions to halt disease transmission. We aimed in this study to provide a pooled estimation of HIV risk factors and trace changes across decades in order to drive consensus and accurate assessment of disease transmission risk. We comprehensively searched PubMed, ISI Web of Knowledge, Medline, EMBASE, ScienceDirect, Ovid, EBSCO, Google Scholar and the Egyptian Universities Library Consortium from October to December 2018. Two independent reviewers extracted data from eligible studies. Funnel plots were inspected to identify publication bias. Heterogeneity across studies was checked using the Q and I2 statistics. The results were reported based on the pooled odds ratio (pOR) with 95% CI using a random-effects model. Meta-analysis of HIV risk factors revealed a superior role for risky sexual practices (unprotected vaginal/anal sex), injecting drug use (IDU), sharing needles, sexually transmitted infections (STIs), child sexual abuse and vertical transmissions. Trends across decades (1982-1999 and 2000-2018, respectively) showed rising evidence for prostitution [pOR (95% CI)= 2.3 (1.12-4.68) versus 2.69 (1.67-4.32)] and men who have sex with men (MSM) [pOR (95% CI)= 2.28 (1.64-3.17) versus 3.67 (1.88-7.17)], while transmission through IDU [pOR (95% CI)= 3.42 (2.28-5.12) versus 2.16 (1.74-2.70)], alcoholism [pOR (95% CI)= 2.35 (0.73-7.59) versus 1.71(1.08-2.72)], and sharing syringes [pOR (95% CI)= 6.10 (2.57-14.5) versus 2.70 (2.01-6.35)] showed notable decline. Harm reduction programs and condom use have been recognized as chief HIV prevention strategies, while male circumcision contributed a partial role. Collectively, sexual risk factors continue to be a key driver of the global HIV epidemic. Persistent and emerging risk factors identified in our analysis should constitute the forefront targets of HIV prevention programmes to accelerate efforts towards HIV elimination.
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Affiliation(s)
- Ahmed F Kabapy
- Fellow of Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.,Department of Endemic and Infectious Diseases, Alexandria Fever Hospital, Alexandria, Egypt
| | - Hanan Z Shatat
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ekram W Abd El-Wahab
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Shamu S, Shamu P, Machisa M. Factors associated with past year physical and sexual intimate partner violence against women in Zimbabwe: results from a national cluster-based cross-sectional survey. Glob Health Action 2018; 11:1625594. [PMID: 31232228 PMCID: PMC6598507 DOI: 10.1080/16549716.2019.1625594] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/09/2019] [Indexed: 12/28/2022] Open
Abstract
Background: Intimate partner violence (IPV) against women continues to be a public health burden globally. Objectives: To assess prevalence and factors associated with women's experiences of past 12 months physical/sexual IPV Methods: A two-stage cluster-based national cross-sectional survey in which women were randomly selected for participation was conducted among 5295 women aged 15-49 years. IPV in the last 12 months was assessed using the WHO interviewer-administered questionnaire for measuring violence against women. Participants' wife beating attitudes, partner controlling behaviours, household decision-making, STI history, HIV status and demographic characteristics were assessed. Multivariate logistic regression was conducted to assess factors associated with IPV. Results: Of the 5292 women interviewed, mean age was 31.5 years and 84.7% were married. Over one-fifth of the women (20.2: 95%CI 19.1-21.3) were physically/sexually abused in the last 12 months. IPV was associated with gender inequitable norms and practices which include lacking household decision-making power (aOR 2.05, 1.71-2.47), experiencing low (aOR 2.05; 1.71-2.47) or high (aOR 4.5; 3.62-5.60) partner controlling behaviours (vs none) and endorsing low (aOR 1.29) or high (aOR 1.36) wife beating attitudes (vs none), having sexual self-efficacy (aOR 1.19; 1.10-1.41), experiencing emotional abuse (aOR 4.50; 3.62-5.60) and having a sexually transmitted infection (STI) (aOR 1.36, 1.04-1.77). IPV was also associated with women's empowerment factors including possessing household assets (aOR 1.26, 1.03-1.54) and reporting current media usage (aOR 1.29; 1.04-1.61). Demographic factors associated with IPV were age and number of children. Conclusions: This study provides evidence that IPV is a significant public health and societal problem as one in five women were abused in the past year. Younger women, less empowered women, women in inequitable intimate relationships and women endorsing traditional gender norms were at increased risk of abuse. IPV prevention programmes must prioritise transforming traditional gender norms and women's economic empowerment.
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Affiliation(s)
- Simukai Shamu
- Health Systems Strengthening Division, Foundation for Professional Development, Pretoria, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Patience Shamu
- School of Clinical Medicine, Faculty of Health Sciences, Wits Reproductive Health and HIV Institute, Johannesburg, South Africa
| | - Mercilene Machisa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Gender and Health Division, South African Medical Research Council, Pretoria, South Africa
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