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Thiaw Y, Nyothach E, Zulaika G, van Eijk AM, Fwaya E, Obor D, Phillips-Howard P, Mason L. "He'll come with some sugar." A qualitative study exploring the drivers and consequences of schoolgirls transactional sex behaviours. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1325038. [PMID: 38800526 PMCID: PMC11119281 DOI: 10.3389/frph.2024.1325038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
Intoduction Transactional sex (TS) is common in areas of sub-Saharan Africa, motivated by reasons beyond financial support. Through this qualitative study we sought to understand the motivation driving TS among adolescent schoolgirls in rural western Kenya where rates are reportedly high. Identifying and understanding drivers within the local context is necessary for implementation of successful public health policy and programming to reduce the associated harms impacting health and wellbeing. Methods To understand the drivers of sexual behaviors, individual views, and socio-cultural norms, we spoke with schoolgirls, male peers, parents and teachers. The three latter groups may influence, encourage, and shape girls' views and behaviors and thus contribute to the perpetuation of cultural and societal norms. Results One hundred and ninety-nine participants took part across 20 FGDs; 8 comprised of schoolgirl groups, and 4 each of schoolboy, parent or teacher groups. Through thematic analysis, poverty emerged as the key driver of TS and a normative behaviour amongst secondary school girls. Subthemes including parental influence, need for menstrual pads, pressure from boda boda drivers, peer pressure, and blame were part of a complex relationship linking poverty with TS. Discussion We conclude that whilst TS is perceived as inevitable, normal and acceptable it is not really a choice for many girls. Exploring ways to encourage communication between families, including around menstruation, may help enable girls to ask for help in acquiring essential items. In addition, education at a community level may shift social norms over time and decrease the prevalence of age-disparate TS among schoolgirls and older, wealthier men in the community.
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Affiliation(s)
- Yandé Thiaw
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Elizabeth Nyothach
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisian, Kenya
| | - Garazi Zulaika
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Anna Maria van Eijk
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Eunice Fwaya
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisian, Kenya
| | - David Obor
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisian, Kenya
| | - Penelope Phillips-Howard
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Linda Mason
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Perry Mohling EW, Recinos M, Kwiringira JN, Phung E, Olwit C, Swahn MH, Massetti G, Self-Brown S. Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho. CHILD ABUSE & NEGLECT 2024; 150:106701. [PMID: 38402043 PMCID: PMC11238702 DOI: 10.1016/j.chiabu.2024.106701] [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] [Received: 05/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa. OBJECTIVES, PARTICIPANTS, SETTING We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho. METHODS Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data. RESULTS Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females. CONCLUSIONS Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.
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Affiliation(s)
- Elizabeth W Perry Mohling
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA.
| | - Manderley Recinos
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Erick Phung
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Connie Olwit
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Monica H Swahn
- WellStar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA; National SafeCare Training and Research Center, Georgia State University, Atlanta, GA, USA; Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Chimoyi L, Ndini P, Oladimeji M, Seatlholo N, Mawokomatanda K, Charalambous S, Setswe G. Exploring the syndemic interaction between social, environmental and structural contexts of HIV infection in peri-mining areas in South Africa: a qualitative study. BMJ Open 2024; 14:e076198. [PMID: 38521520 PMCID: PMC10961556 DOI: 10.1136/bmjopen-2023-076198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE To explore the syndemic interaction between social, environmental, and structural contexts and HIV infection in peri-mining areas in South Africa. DESIGN Mixed qualitative methods consisting of in-depth interviews (IDIs) and focus group discussions (FGDs) exploring the interaction between HIV infection and the social, environmental and structural factors affecting people living in the peri-mining areas of South Africa. Themes were analysed following the syndemic theoretical framework. SETTING Participants were recruited from three mining companies and locations in the peri-mining communities surrounding the mining companies in Limpopo, Mpumalanga, and Northern Cape provinces. PARTICIPANTS Inclusion criteria included mineworkers, healthcare workers, female sex workers (FSWs), injection drug users (IDUs), and other community members, ≥18 years, living in the peri-mining area at the time of participation. Three FGDs were conducted (n=30): 13 men and 17 women aged 18-55 years. IDIs were conducted with 45 participants: mineworkers (n=10), healthcare workers (n=11), FSWs (n=15), truck drivers (n=4) and IDUs (n=5). RESULTS The findings from this study indicate that a syndemic of four socio-behavioural factors is associated with HIV acquisition in peri-mining areas. These are migrancy, accessibility to alcohol and substance use, commercial and transactional sex, and uptake of HIV prevention services. CONCLUSIONS Our findings have implications for HIV prevention programmes in mining companies, which rely on male condom usage promotion. More emphasis on better education about HIV prevalence, transmission and up-to-date prevention alternatives, such as pre-exposure prophylaxis for mineworkers is recommended. Furthermore, collaboration with community-based organisations is recommended to wholly address the syndemic factors influencing HIV transmission in peri-mining communities.
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Affiliation(s)
- Lucy Chimoyi
- Implementation Research, The Aurum Institute, Johannesburg, South Africa
| | - Pretty Ndini
- Implementation Research, The Aurum Institute, Johannesburg, South Africa
| | - Matthew Oladimeji
- Implementation Research, The Aurum Institute, Johannesburg, South Africa
| | - Nieser Seatlholo
- Implementation Research, The Aurum Institute, Johannesburg, South Africa
| | | | - Salome Charalambous
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa
| | - Geoffrey Setswe
- Implementation Research, The Aurum Institute, Johannesburg, South Africa
- Department of Health Studies, University of South Africa, Pretoria, South Africa
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Shangani S, Masa R, Zimba M, Zimba G, Operario D. Food insecurity and depressive symptoms among young people living with HIV in Eastern Zambia. Int J STD AIDS 2024; 35:25-32. [PMID: 37707955 DOI: 10.1177/09564624231201917] [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] [Indexed: 09/16/2023]
Abstract
Background: Mental health problems are common among people living with HIV/AIDS and contribute to poor HIV-related outcomes, including AIDS-related mortality. We examined the association between severe food insecurity and depressive symptoms in young people living with HIV (YPLH) in Zambia. Methods: We sampled 120 youth living with HIV aged 18-21 years in the Eastern Province of Zambia. Household food insecurity was measured using the Household Food Insecurity Access Scale (HFIAS). Mental health was assessed using the Children's Depression Inventory-Short Form. We fitted linear regression models to assess whether food insecurity is associated with depressive symptoms. Results: The mean age was 19 years, and 63% were female. Overall, 43% were severely food insecure. After adjusting for sociodemographic variables and other confounders, severely food insecure participants were more likely to report depressive symptoms (β = 0.81, 95% Confidence Interval [CI] 0.07-1.55) and engagement in sex work (β = 1.78, 95% CI 0.32-3.25). Conclusion: Almost half of the sample reported severe food insecurity which was associated with depressive symptoms. Interventions aimed at improving food insecurity may have beneficial effects on mental health and HIV outcomes among young people living with HIV in resource-limited settings.
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Affiliation(s)
- Sylvia Shangani
- School of Public Health, Department of Community Health Sciences, Boston University, Boston, MA, USA
| | - Rainier Masa
- School of Social Work, University of North Carolina, Chapel Hill, NC, USA
| | - Mathias Zimba
- Rising Fountains Development Program, Lundazi, Zambia
| | - Gilbert Zimba
- Rising Fountains Development Program, Lundazi, Zambia
| | - Don Operario
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Muyinda H, Jongbloed K, Zamar DS, Malamba SS, Ogwang MD, Katamba A, Oneka A, Atim S, Odongpiny TO, Sewankambo NK, Schechter MT, Spittal PM. Cango Lyec (Healing the Elephant): HIV Prevalence and Vulnerabilities Among Adolescent Girls and Young Women in Postconflict Northern Uganda. J Acquir Immune Defic Syndr 2023; 94:95-106. [PMID: 37276188 PMCID: PMC10497204 DOI: 10.1097/qai.0000000000003234] [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: 09/28/2022] [Accepted: 04/21/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Adolescent girls and young women younger than 25 years (AGYW) account for disproportionate HIV infections in sub-Saharan Africa. Impacts of war in Northern Uganda continue to affect HIV-related health and wellbeing of young people postconflict. Prevalence and incidence of HIV infection were estimated, and factors associated with HIV prevalence among sexually active AGYW in Northern Uganda were investigated. METHODS Cango Lyec is a cohort involving conflict-affected populations in Northern Uganda. Nine randomly selected communities in Gulu, Nwoya, and Amuru districts were mapped. House-to-house census was conducted. Consenting participants aged 13-49 years were enrolled over 3 study rounds (2011-2015), of whom 533 were AGYW and had ever had sex. Data were collected on trauma, depression, and sociodemographic-behavioral characteristics. Venous blood was taken for HIV and syphilis serology. Multivariable logistic regression determined baseline factors associated with HIV prevalence. RESULTS HIV prevalence among AGYW was 9.7% (95% CI: 7.3 to 12.6). AGYW living in Gulu (adjusted risk ratio, aRR: 2.48; 95% CI: 1.12 to 5.51) or Nwoya (aRR: 2.65; 95% CI: 1.03 to 6.83) were more likely than in Amuru to be living with HIV. Having self-reported genital ulcers (aRR: 1.93; 95% CI: 0.97 to 3.85) or active syphilis (aRR: 3.79; 95% CI: 2.35 to 6.12) was associated with increased risk of HIV infection. The likelihood of HIV was higher for those who experienced sexual violence in the context of war (aRR: 2.37; 95% CI: 1.21 to 4.62) and/or probable depression (aRR: 1.95; 95% CI: 1.08 to 3.54). HIV incidence was 8.9 per 1000 person-years. CONCLUSION Ongoing legacies of war, especially gender violence and trauma, contribute to HIV vulnerability among sexually active AGYW. Wholistic approaches integrating HIV prevention with culturally safe initiatives promoting sexual and mental health in Northern Uganda are essential.
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Affiliation(s)
- Herbert Muyinda
- Child Health Development Center, Makerere University, Kampala, Uganda
| | - Kate Jongbloed
- BC Office of the Provincial Health Officer, Victoria, Canada
| | - David S. Zamar
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- BC Children's Hospital Research Institute, Vancouver, Canada
| | | | | | - Achilles Katamba
- College of Health Sciences, Makerere University, Kampala, Uganda; and
| | | | | | | | | | - Martin T. Schechter
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Patricia M. Spittal
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- BC Children's Hospital Research Institute, Vancouver, Canada
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Mihretie GN, Kassa BG, Ayele AD, Liyeh TM, Belay HG, Miskr AD, Minuye B, Azanaw MM, Worke MD. Transactional sex among women in Sub-Saharan Africa: A systematic review and meta-analysis. PLoS One 2023; 18:e0286850. [PMID: 37289839 PMCID: PMC10249834 DOI: 10.1371/journal.pone.0286850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. In Sub-Saharan Africa, several primary studies have been conducted in various countries to examine the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. METHOD Data source: PubMed, Google Scholar, HINARI, the Cochrane Library, and grey literature were searched from March 6 to April 24, 2022, and included studies conducted from 2000 to 2022. The pooled prevalence of transactional sex and associated factors was estimated using Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic, a funnel plot, and Egger's test were used to check for heterogeneity and publication bias, respectively. A subgroup analysis was done based on the study years, source of data, sample sizes, and geographical location. RESULTS The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55% (9.59%-15.52%). Early sexual debut (OR = 2.58, 95% CI: 1.56, 4.27), substance abuse (OR = 4.62, 95% CI: 2.62, 8.08), history of sexual experience (OR = 4.87, 95% CI: 2.37, 10.02), physical violence abuse (OR = 6.70, 95% CI: 3.32, 13.53), orphanhood (OR = 2.10, 95% CI: 1.27, 3.47), and sexual violence abuse (OR = 3.76, 95% CI: 1.08, 13.05) were significantly associated with transactional sex. CONCLUSION The prevalence of transactional sex among women in sub-Saharan Africa was high. Alcohol consumption, substance abuse, early sex debuts, having a history of sexual experiences, physical violence, and sexual violence increased the practice of transactional sex.
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Affiliation(s)
- Gedefaye Nibret Mihretie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bekalu Getnet Kassa
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemu Degu Ayele
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Habtamu Gebrehana Belay
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Agernesh Dereje Miskr
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Binyam Minuye
- School of Public health at University of Technology Sydney, Sydney, Australia
| | - Melkalem Mamuye Azanaw
- Department of Social and Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulugeta Dile Worke
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Scott S, Lavage DR, Acharya G, Risser L, Bocinski SG, Walker EA, Randell KA, Ragavan MI, Miller E. Experiences of Exploitation and Associations With Economic Abuse in Adolescent Dating Relationships: Findings From a U.S. Cross-Sectional Survey. J Trauma Dissociation 2023:1-17. [PMID: 37183437 DOI: 10.1080/15299732.2023.2212404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Adolescent relationship abuse (ARA) (i.e. physical, sexual, psychological, or economic abuse in the context of romantic relationships) is associated with adverse health outcomes, including anxiety, depression, suicidality, unintended pregnancy, and substance misuse. A related phenomenon, reproductive coercion involves interference with the reproductive decision making of a partner with the intention of promoting pregnancy or controlling outcomes of a pregnancy. Reproductive coercion is associated with unintended pregnancy, partner violence, and sexually transmitted infections. Little is known about the intersection between economic ARA, sexual exploitation, and reproductive coercion. This paper explores the intersections between reproductive coercion, transactional sex, and economic abuse victimization in adolescent dating relationships. In an online survey, 1,752 adolescents (ages 13-17) were asked about economic adolescent relationship abuse (educational, employment and financial interference), transactional sex, reproductive coercion, and contraceptive access within their relationships. We assessed associations with chi-square tests and logistic regression analysis. Youth who experienced economic ARA (70%, 1,232) reported financial dependence on their partner, contraceptive access, and reproductive coercion (74-83%; p-values<0.001) more often than their counterparts without economic ARA. Adolescents experiencing economic abuse were more likely to report transactional sex (aOR = 2.76, CI [2.12, 3.60], p < .001), depending on a partner to pay for contraception or birth control (aOR = 2.20, CI [1.71, 2.84], p < .001), and reproductive coercion (aOR = 3.20, CI [2.37, 4.32], p < .001). Youth-serving providers and agencies should be aware of intersections between economic ARA, transactional sex, financial dependence, and reproductive coercion, particularly for adolescents with health-related social needs.
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Affiliation(s)
- Sarah Scott
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Daniel R Lavage
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Geeta Acharya
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lauren Risser
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Elizabeth A Walker
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kimberly A Randell
- Department of Pediatrics, Children's Mercy, Kansas, Missouri, USA
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas, Missouri, USA
- Department of Pediatrics, University of Kansas School of Medicine, Kansas, Kansas, USA
| | - Maya I Ragavan
- Division of General Academic Pediatrics, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Kisaakye P, Bukuluki P, Nabulya A, Nakijoba B, Kasirye R, Mutaawe R. Substance use and watching pornography are drivers of transactional sex: evidence from young women receiving care from Uganda Youth Development Link. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2183907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Peter Kisaakye
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Paul Bukuluki
- Department of Social Work and Social Administration, School of Social Sciences, Makerere University, Kampala, Uganda
| | - Anna Nabulya
- Department of Programmes and Research, Uganda Youth Development Link, Kampala, Uganda
| | - Barbara Nakijoba
- Department of Programmes and Research, Uganda Youth Development Link, Kampala, Uganda
| | - Rogers Kasirye
- Department of Programmes and Research, Uganda Youth Development Link, Kampala, Uganda
| | - Rogers Mutaawe
- Department of Programmes and Research, Uganda Youth Development Link, Kampala, Uganda
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Picchetti V, Stamatakis C, Annor FB, Massetti GM, Hegle J. 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. CHILD ABUSE & NEGLECT 2022; 134:105916. [PMID: 36215756 PMCID: PMC9691579 DOI: 10.1016/j.chiabu.2022.105916] [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] [Received: 03/02/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Viani Picchetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - Caroline Stamatakis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jennifer Hegle
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Chan ASW, Leung LM, Li JSF, Ho JMC, Tam HL, Hsu WL, Iu ANOS, Tang PMK, Yan E. Impacts of psychological wellbeing with HIV/AIDS and cancer among sexual and gender minorities: A systematic review and meta-analysis. Front Public Health 2022; 10:912980. [PMID: 36523575 PMCID: PMC9746694 DOI: 10.3389/fpubh.2022.912980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing. Objective The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing. Methods This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse. Results The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from -10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990-1.560, Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from -8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 (95% CI was 10.05-14.92, Test Z-value was 268.40, P-value was <0.1). Conclusion Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing.
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Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China,*Correspondence: Alex Siu Wing Chan ;
| | - Lok Man Leung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jane Siu Fan Li
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jacqueline Mei Chi Ho
- Faculty of Health and Social Sciences, School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Hon Lon Tam
- Faculty of Medicine, Nethersole School of Nursing, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wing Leung Hsu
- Aceso Medical Centre, Hong Kong, Hong Kong SAR, China,Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, United Kingdom
| | - April Nicole On Sang Iu
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Patrick Ming Kuen Tang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Elsie Yan
| | - Elsie Yan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China,Patrick Ming Kuen Tang
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Myat Zaw AM, Win NZ, Thepthien BO. Adolescents’ academic achievement, mental health, and adverse behaviors: Understanding the role of resilience and adverse childhood experiences. SCHOOL PSYCHOLOGY INTERNATIONAL 2022. [DOI: 10.1177/01430343221107114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the relationship between exposure to adverse childhood experiences (ACEs) and health in adolescents with high or low levels of resilience. Data came from the 2020 Bangkok Behaviour Surveillance Survey (BBSS). Multivariate logistic regression analyses examined associations between ACEs and health conditions overall, and for adolescents with low versus high resilience on the Grotberg’s Resilience Scale. Overall, 54.9% of adolescents reported 0 ACEs. Compared to adolescents with no ACEs, it was found that those with ≥ 1 ACE were more likely to experience insomnia, sadness, suicide attempt, depression, and excess alcohol consumption. Those with a history of four or more ACEs had worse mental health, higher total undesirable behaviour, and lower academic achievement. When the sample was divided into high resilience (60.2%) and low resilience (39.8%), having at least 1 ACEs (vs. 0 ACEs) was associated with worse mental health and undesirable behaviour in adolescents with low resilience. History of ACEs can predict adverse health conditions and undesirable behaviour among adolescents, and the strongest correlation is among adolescents with low resilience. Future studies are needed to develop strategies and interventions to increase adolescent resilience, and test whether improvements in resilience reduce the adverse impact of ACEs on adolescent mental/behavioural health.
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Affiliation(s)
- Aye Myat Myat Zaw
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Nay Zar Win
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Bang-on Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
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Villaveces A, Shankar V, Palomeque F, Padilla M, Kress H. Association between violence and mental distress, self-harm and suicidal ideation and attempts among young people in Malawi. Inj Prev 2022; 28:injuryprev-2021-044510. [PMID: 35523567 PMCID: PMC10895876 DOI: 10.1136/injuryprev-2021-044510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/01/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Mental health problems ranging from depression to more severe acts such as self-harm or suicidal behaviours are a serious problem among adolescents and young adults. Exposure to violence during the life of young people can increase mental health issues for youth. This study examines the relationship between exposure to violence and mental health issues among youth using a nationally representative study in Malawi. METHODS We analysed data from the nationally representative Violence Against Children Survey from Malawi (2013) to quantify the association between exposures to violence (physical, sexual and emotional) and their relationship with mental distress, self-harm behaviours and suicidal ideation and attempts among youth aged 13-24 years. We evaluated the association of exposures to violence against children with reported mental health conditions among women and men. We used ordinal logistic regression models with appropriate survey weights to assess exposures to violence and the three outcomes of interest. RESULTS Children and youth aged 13-24 years exposed to violence in childhood reported higher levels of adverse mental health effects, including mental distress, self-harm behaviours and suicidal ideation and attempts. The odds of reporting these outcomes increased as the number of violence types increased. CONCLUSIONS Understanding the risks based on different combinations of exposures to violence in Malawi can help identify populations at higher risk and optimise violence prevention strategies.
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Affiliation(s)
- Andrés Villaveces
- Division of Violence Prevention, NCIPC, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Francisco Palomeque
- State, Tribal, Local, and Territorial Task Support Force, COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mabel Padilla
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Howard Kress
- Division of Violence Prevention, NCIPC, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Self-Reported Prevalence of HIV Infection, Sexually Transmitted Infections and Risky Sexual Behavior among Mental Health Care Users Accessing Healthcare Services in Tshwane District, South Africa. Healthcare (Basel) 2021; 9:healthcare9101398. [PMID: 34683080 PMCID: PMC8536192 DOI: 10.3390/healthcare9101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
The rate of HIV and sexually transmitted infections among mental patients is higher than that of the general population worldwide. Many risky sexual behaviors are associated with mental illness. However, mental health care users (MHCUs) are not specifically targeted for HIV preventative care, and routine HIV testing is not done among this population. Limited studies have investigated self-reported HIV and STI prevalence and associated risky sexual behavior in persons with mental illnesses accessing health care services in South Africa in particular. This study set out to determine both the Sexually Transmitted Infections (STI) and human immunodeficiency virus (HIV) self-reported prevalence and sexual practices of MHCUs. A descriptive cross-sectional survey using purposive sampling was used to select 107 MHCUs across five clinics within Gauteng Province of South Africa who were above the age of 18, had a mental illness, and were currently stable and receiving chronic medication. Descriptive statistics were performed using Stata IC version 16. The chi square test was used to indicate statistical significance (p < 0.05) of differences in frequency distributions. More males (52.5%) than females were currently in a sexual relationship (50.0%), having multiple sexual partners (n = 4.13%), and having alcohol-driven sex (n = 4.19%). The majority of MHCUs (n = 82.77%) had an STI in the past six months, and a quarter (n = 21.25%) were HIV-positive with over two-thirds of MHCU (n = 69.70%) perceiving themselves not at risk for HIV. MHCUs engaged in risky behaviors had a low perception of the risks of contracting HIV. Bivariate analysis of gender by sexual behavior revealed that female MHCUs are more at risk of being forced to have sex compared to males (p = 0.006). Integrated interventions should be put in place to ensure that MHCUs' sexual and reproductive health are not left behind and issues such as sexual education, safe sex, and sexually transmitted infections should form part of the care of MHCUs.
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