1
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Kanagasabai U, Thorsen V, Zhu L, Annor FB, Chiang L, McOwen J, Augusto A, Manuel P, Kambona C, Coomer R, Kamagate F, Ramphalla P, Denhard L, Cain M, Hegle J, de Barros RB, Saenz S, Kamami M, Patel P. Adverse childhood experiences, HIV and sexual risk behaviors - Five sub-Saharan countries, 2018-2020. Child Abuse Negl 2024; 150:106541. [PMID: 38114359 DOI: 10.1016/j.chiabu.2023.106541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023]
Abstract
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. 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). 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. 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. 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.
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Affiliation(s)
| | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Laura Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Meagan Cain
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jennifer Hegle
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Shantal Saenz
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
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2
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Denhard L, Brown C, Kanagasabai U, Thorsen V, Kambona C, Kamagate F, Ramphalla P, Benevides R, Kamami M, McOwen J, Augusto A, Manuel P, Coomer R, Matthews S, Patel P, Annor FB. Service-seeking behaviors among male victims of violence in five African countries: The effects of positive and adverse childhood experiences. Child Abuse Negl 2024; 150:106452. [PMID: 37704546 DOI: 10.1016/j.chiabu.2023.106452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Violence against boys and men is widely under-reported. Boys and men face unique and gendered barriers to accessing services following experiences of violence. PARTICIPANTS AND SETTING The study is a secondary data analysis of five nationally representative population-based Violence Against Children and Youth Surveys (VACS) conducted in Kenya (2019), Côte d'Ivoire (2018), Lesotho (2018), Mozambique (2019), and Namibia (2019). Analysis was limited to males between 18 and 24 years who experienced lifetime physical or sexual violence. OBJECTIVE AND METHODS We analyzed the association between positive and adverse childhood experiences (PCEs and ACEs), and seeking post-violence services among males using bivariate chi-squared tests and multivariable logistic regression. RESULTS 8.02 % (5.55-10.50 %) of male victims between the ages of 18 and 24 sought services for any lifetime physical or sexual violence. Witnessing interparental violence and experiencing death of one or both parents were each associated with increased odds of having sought post-violence services (aOR 2.43; 95 % CI: 1.25-4.79; aOR 2.27; 95 % CI: 1.14-4.50), controlling for education, violence frequency, and violence type. High parental monitoring was associated with increased odds of service seeking (aOR 1.79; 95 % CI: 1.02-3.16), while strong father-child relationship was associated with lower odds (aOR 0.45; 95 % CI: 0.23-0.89). CONCLUSION These findings contribute to limited research on service-seeking behaviors among men and boys. While some parent-youth relationship factors were associated with higher odds of service-seeking, the outcome remained rare. Age and gender-related barriers should be addressed where post-violence care services are offered.
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Affiliation(s)
- Langan Denhard
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Viva Thorsen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Fathim Kamagate
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Côte d'Ivoire
| | - Puleng Ramphalla
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Lesotho
| | - Regina Benevides
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Mwikali Kamami
- Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jordan McOwen
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Pragna Patel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
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Miedema SS, Stamatakis C, Tracy A, Hegle J, Kamagate MF, McOwen J, Augusto A, Manuel P, Coomer R, Kambona C, Ramphalla P, Niolon P, Patel P, Annor FB. Patterns of adverse childhood experiences and their associations with mental distress, substance use and sexual risk behaviors in Sub-Saharan Africa. Child Abuse Negl 2024; 150:106494. [PMID: 37806930 DOI: 10.1016/j.chiabu.2023.106494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/02/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Multiple adverse childhood experiences (ACEs) are associated with poor sexual and mental health outcomes in low- and middle-income countries (LMICs). Less well understood is how discrete and gendered clustering of ACEs may influence health. OBJECTIVE To assess how multiple ACEs co-occur and how dominant patterns of co-occurrence are associated with mental distress, substance use, and sexual risk behaviors among young women and men in Sub-Saharan Africa. PARTICIPANTS AND SETTING We used pooled data of young men and women aged 19-24 from comparable, nationally representative Violence Against Children and Youth Surveys (VACS) conducted in Cote d'Ivoire, Kenya, Lesotho, Mozambique, and Namibia (nf = 7183; nm = 2207). METHODS We estimated sex-disaggregated latent classes of six ACEs among young women and men. We ran Bolck-Croon-Hagenaars (BCH) distal outcome analysis to test the sex-stratified relationships between ACEs latent classes and health outcomes. RESULTS A six class solution best fit the female data. Classes included witnessing violence and experiencing physical violence (PV); experiencing PV; high ACEs; witnessing community violence; orphanhood; and low ACEs exposure. Among males, the best-fitting three-class solution included experiencing PV and witnessing community violence; high ACEs; and low ACEs exposure. Membership in the high ACEs class was associated with mental distress among females and males, and substance use among males. No differences in sexual risk behavior were identified by class membership among either females or males. CONCLUSIONS Discrete clusters of co-occurring ACEs are associated with elevated odds of mental distress among females, and mental distress and substance use among males. Preventing ACEs may improve mental health among young women and men in LMICs in Sub-Saharan Africa.
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Affiliation(s)
- Stephanie Spaid Miedema
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Caroline Stamatakis
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Rwanda
| | | | - Jennifer Hegle
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jordan McOwen
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | | | - Pedro Manuel
- Centers for Disease Control and Prevention, Maputo, Mozambique
| | - Rachel Coomer
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | | | | | - Phyllis Niolon
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pragna Patel
- Division of Global HIV/TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Annor FB, Amene EW, Zhu L, Stamatakis C, Picchetti V, Matthews S, Miedema SS, Brown C, Thorsen VC, Manuel P, Gilbert LK, Kambona C, Coomer R, Trika J, Kamuingona R, Dube SR, Massetti GM. Parental absence as an adverse childhood experience among young adults in sub-Saharan Africa. Child Abuse Negl 2024; 150:106556. [PMID: 37993366 PMCID: PMC10961199 DOI: 10.1016/j.chiabu.2023.106556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/18/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Parental absence in childhood has been associated with multiple negative consequences, such as depression and anxiety in young adulthood. OBJECTIVE To assess whether parental absence for six months or more in childhood is associated with poor mental health and substance use in young adulthood and whether parental absence accounts for additional variance beyond those explained by other adverse childhood experiences (ACEs) among youth in sub-Saharan Africa. PARTICIPANTS AND SETTINGS We used combined Violence Against Children and Youth Survey (VACS) data from Cote d'Ivoire (2018), Lesotho (2018), Kenya (2019), Namibia (2019), and Mozambique (2019). Analyses were restricted to 18-24-year-olds (nf = 7699; nm = 2482). METHODS We used logistic regression to examine sex-stratified relationships between parental absence in childhood (defined as biological mother or father being away for six months or more before age 18) and mental health problems and substance use and whether parental absence explained additional variance beyond those explained by other ACEs. RESULTS In sub-Saharan Africa, parental absence in childhood was common (30.5 % in females and 25.1 % in males), significantly associated with poor mental health and substance use among females and males and accounted for additional variance beyond those explained by conventional ACEs. For example, after controlling for study covariates and other ACEs, females who experienced any parental absence had 1.52 (95 % CI = 1.02-2.26) higher odds of experiencing moderate/serious psychological distress compared with those who did not. CONCLUSION The observed association between parental absence and poor mental health suggests that this experience has significant adverse consequences and merits consideration as an ACE.
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Affiliation(s)
- Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States; United States Public Health Service Commissioned Corps, United States.
| | - Ermias W Amene
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Liping Zhu
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Caroline Stamatakis
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Rwanda
| | - Viani Picchetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Sarah Matthews
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Stephanie S Miedema
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Colvette Brown
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Viva C Thorsen
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Pedro Manuel
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Mozambique
| | - Leah K Gilbert
- United States Public Health Service Commissioned Corps, United States; Office of the Chief Operating Officer, Office of Safety, Security and Asset Management, Occupational Health Clinic, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Caroline Kambona
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kenya
| | - Rachel Coomer
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Namibia
| | | | | | - Shanta R Dube
- Levine College of Public Health Program, Wingate University, Wingate, NC, United States
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
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5
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Seya MKS, Matthews S, Zhu L, Brown C, Lefevre A, Agathis N, Chiang LF, Annor FB, McOwen J, Augusto A, Manuel P, Kamagate MF, Nobah MT, Coomer R, Kambona C, Low A. Parenting-related positive childhood experiences, adverse childhood experiences, and mental health-Four sub-Saharan African countries. Child Abuse Negl 2024; 150:106493. [PMID: 37839988 DOI: 10.1016/j.chiabu.2023.106493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are associated with poor mental health outcomes and risk-taking behaviors. Positive childhood experiences (PCEs) may mitigate these negative impacts. OBJECTIVE This study 1) assessed the associations between ACEs and negative health outcomes and risk-taking behaviors among young adults, and 2) evaluated whether - and which - PCEs moderate the association between ACEs and these outcomes in sub-Saharan Africa. METHODS This multi-country analysis combined cross-sectional representative survey data from young adults, ages 18-24 years, from the 2019 Kenya, 2018 Lesotho, 2019 Mozambique, and 2019 Namibia Violence Against Children and Youth Surveys. The association between experiencing any ACEs and each health outcome was assessed using Wald's chi-square tests. Multivariable logistic regression analyses assessed the association between each PCE and each outcome of interest. RESULTS Females who experienced any ACEs had higher odds of experiencing moderate to severe mental distress (aOR = 2.7, 95%CI: 1.9, 3.9). Males who experienced any ACEs had higher odds of experiencing suicidal/self-harm behaviors (aOR = 6.7, 95%CI: 2.8, 16.0) and substance use (aOR = 2.5, 95%CI: 1.4, 4.2). In females, strong mother-child relationship was protective against moderate to severe mental distress (aOR = 0.7, 95%CI: 0.6, 0.9), suicidal/self-harm behaviors (aOR = 0.6, 95%CI: 0.4, 0.9), and substance use (aOR = 0.6, 95%CI: 0.4, 0.9). For males, a strong mother-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.5, 95%CI: 0.2, 0.9), and a strong father-child relationship was protective against suicidal/self-harm behaviors (aOR = 0.4, 95%CI: 0.2, 0.7) and substance use (aOR = 0.6, 95%CI: 0.4, 0.8). CONCLUSIONS Strong parenting programs may likely play an important role in improving the psychosocial health of young adults.
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Affiliation(s)
| | - Sarah Matthews
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Liping Zhu
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Adrienne Lefevre
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Nickolas Agathis
- Division of Global HIV and Tuberculosis, Center for Global Health Centers for Disease Control and Prevention, GA, USA
| | - Laura F Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Francis B Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, GA, USA
| | - Jordan McOwen
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | | | - Pedro Manuel
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | - Maman Fathim Kamagate
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Marie-Therese Nobah
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d'Ivoire
| | - Rachel Coomer
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia
| | - Caroline Kambona
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya
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6
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Agathis NT, Annor FB, Xu L, Swedo E, Chiang L, Coomer R, Hegle J, Patel P, Forster N, O’Malley G, Ensminger AL, Kamuingona R, Andjamba H, Nshimyimana B, Manyando M, Massetti GM. Strong Father-Child Relationships and Other Positive Childhood Experiences, Adverse Childhood Experiences, and Sexual Risk Factors for HIV among Young Adults Aged 19-24 Years, Namibia, 2019: A Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:6376. [PMID: 37510608 PMCID: PMC10378761 DOI: 10.3390/ijerph20146376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
Using cross-sectional data from the 2019 Namibia Violence Against Children and Youth Survey and sex-stratified multivariable models, we assessed the associations between four different positive childhood experiences (PCEs) and having ≥3 adverse childhood experiences (ACEs), including ≥3 ACE-PCE interaction terms, and seven sexual risk factors for HIV acquisition among young adults aged 19-24 years. One PCE, having a strong father-child relationship, was inversely associated with two risk factors among women (lifetime transactional sex (OR, 0.4; 95% CI, 0.2-0.7) and recent age-disparate sexual relationships (OR, 0.3; 95% CI, 0.2-0.5)), and significantly interacted with having ≥3 ACEs for three risk factors among women (not knowing a partner's HIV status, infrequently using condoms, and ever having an STI) and one among men (having multiple sexual partners in the past year). The other PCEs were significantly associated with ≤1 HIV risk factor and had no significant interaction terms. Strong father-child relationships may reduce HIV acquisition risk and mitigate the effect of childhood adversity on HIV risk among young adults in Namibia.
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Affiliation(s)
- Nickolas T. Agathis
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Francis B. Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Likang Xu
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Elizabeth Swedo
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Laura Chiang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Rachel Coomer
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Private Bag, Windhoek 12029, Namibia
| | - Jennifer Hegle
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Pragna Patel
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Norbert Forster
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Gabrielle O’Malley
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Alison L. Ensminger
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Rahimisa Kamuingona
- Ministry of Gender Equality, Poverty Eradication, and Social Welfare, Private Bag, Windhoek 13359, Namibia
| | - Helena Andjamba
- Ministry of Gender Equality, Poverty Eradication, and Social Welfare, Private Bag, Windhoek 13359, Namibia
| | - Brigitte Nshimyimana
- Ministry of Gender Equality, Poverty Eradication, and Social Welfare, Private Bag, Windhoek 13359, Namibia
| | - Molisa Manyando
- US Agency for International Development, Washington, DC 20004, USA
| | - Greta M. Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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7
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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 Educ Prev 2023; 35:20-38. [PMID: 37406147 DOI: 10.1521/aeap.2023.35.suppa.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [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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Kanagasabai U, Valleau C, Cain M, Chevalier MS, Hegle J, Patel P, Benevides R, Trika JB, Angumua C, Mpingulu M, Ferdinand K, Sida F, Galloway K, Kambona C, Oluoch P, Msungama W, Katengeza H, Correia D, Duffy M, Cossa RMV, Coomer R, Ayo A, Ukanwa C, Tuyishime E, Dladla S, Drummond J, Magesa D, Kitalile J, Apondi R, Okuku J, Chisenga T, Cham HJ. Understanding Gender-Based Violence Service Delivery in CDC-Supported Health Facilities: 15 Sub-Saharan African Countries, 2017-2021. AIDS Educ Prev 2023; 35:39-51. [PMID: 37406144 DOI: 10.1521/aeap.2023.35.suppa.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Gender-based violence (GBV) is a complex issue deeply rooted in social structures, making its eradication challenging. GBV increases the risk of HIV transmission and is a barrier to HIV testing, care, and treatment. Quality clinical services for GBV, which includes the provision of HIV postexposure prophylaxis (PEP), vary, and service delivery data are lacking. We describe GBV clinical service delivery in 15 countries supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention. Through a descriptive statistical analysis of PEPFAR Monitoring, Evaluation, and Reporting (MER) data, we found a 252% increase in individuals receiving GBV clinical services, from 158,691 in 2017 to 558,251 in 2021. PEP completion was lowest (15%) among 15-19-year-olds. Understanding GBV service delivery is important for policy makers, program managers, and providers to guide interventions to improve the quality of service delivery and contribute to HIV epidemic control.
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Affiliation(s)
- Udhayashankar Kanagasabai
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | | | - Meagan Cain
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Michelle S Chevalier
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Jennifer Hegle
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Pragna Patel
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Regina Benevides
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
| | - Joseph B Trika
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Carrine Angumua
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Minlangu Mpingulu
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Kamanga Ferdinand
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Fikirte Sida
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Katelyn Galloway
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Caroline Kambona
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Patricia Oluoch
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Wezi Msungama
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Hans Katengeza
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Della Correia
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Meghan Duffy
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Raquel Maria Violeta Cossa
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Rachel Coomer
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Adeola Ayo
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Chioma Ukanwa
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Elysee Tuyishime
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Sibongile Dladla
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Jennifer Drummond
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Daniel Magesa
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Jane Kitalile
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Rose Apondi
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Jackson Okuku
- The following authors are affiliated with the respective country offices of the Division of Global HIV and TB, CGH, CDC: Joseph B. Trika (Cote d'Ivoire), Carrine Angumua (Cameroon), Minlangu Mpingulu (Democratic Republic of Congo), Fikirte Sida (Ethiopia), Katelyn Galloway (Eswatini), Caroline Kambona and Patricia Oluoch (Kenya), Wezi Msungama (Malawi), Della Correia, and Meghan Duffy (Mozambique), Rachel Coomer (Namibia), Adeola Ayo (Nigeria), Elysee Tuyishime (Rwanda), Sibongile Dladla, and Jennifer Drummond (South Africa), Daniel Magesa, and Jane Kitalile (Tanzania), Rose Apondi (Uganda), and Jackson Okuku (Zambia)
| | - Tina Chisenga
- The following authors are affiliated with their respective country's Ministry of Health: Kamanga Ferdinand (Democratic Republic of Congo), Hans Katengeza (Malawi), Raquel Maria Violeta Cossa (Mozambique), Chioma Ukanwa (Nigeria), and Tina Chisenga (Zambia)
| | - Haddi J Cham
- Division of Global HIV and TB, Center for Global Health (CGH), U.S. Centers for Disease Control and Prevention (CDC), Atlanta Georgia
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Velloza J, Davies LD, Ensminger AL, Theofelus FM, Andjamba H, Kamuingona R, Masseti G, Coomer R, Forster N, O’Malley G. Cycles of Violence Among Young Women in Namibia: Exploring the Links Between Childhood Violence and Adult Intimate Partner Violence From the Violence Against Children and Youth Survey. J Interpers Violence 2022; 37:NP22992-NP23014. [PMID: 35156448 PMCID: PMC9661872 DOI: 10.1177/08862605211073107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: Violence against children is a global public health crisis and is associated with poor mental and physical health outcomes. Childhood violence may also increase the risk of subsequent violence revictimization by an intimate partner. We aimed to understand cycles of violence among adolescent girls and young women in Namibia to inform violence prevention and treatment interventions. Methods: The 2019 Namibia Violence Against Children and Youth Survey (VACS) examined the prevalence of childhood violence and intimate partner violence among 18-24 year old adolescent girls and young women (N = 2434). Using the data, we assessed the prevalence of childhood violence, defined as any physical, sexual, or emotional violence victimization prior to age 18, and estimated the prevalence of intimate partner violence (IPV) after age 18. We used a weighted logistic regression to assess whether childhood violence exposure was associated with subsequent experience of IPV after age 18. Results: Adolescent girls and young women in Namibia had a statistically significant higher odds of experiencing IPV if they had experienced any childhood violence including physical, sexual, and/or emotional violence (adjusted odds ratio [aOR]: 2.93; 95% Confidence Interval [95% CI: 1.64-5.23). IPV was also significantly associated with childhood physical (aOR: 1.81; 95% CI: 1.07-3.05), sexual (aOR: 3.79; 95% CI: 2.54-5.67), or emotional (aOR: 2.39; 95% CI: 1.18-4.86) violence when each were considered separately. We also observed a dose-response relationship between the number of types of childhood violence and IPV experience as a young adult. Conclusions: Childhood violence is a significant predictor of subsequent violence revictimization by an intimate partner. This analysis provides unique insights on cycles of violence among adolescent girls and young women in Namibia and points to the need for interventions during childhood to prevent violence against children and break this cycle among young women in sub-Saharan Africa.
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Affiliation(s)
- Jennifer Velloza
- University of Washington, Department of Global Health, Seattle, WA, USA
| | - Luke D. Davies
- University of Washington, Department of Global Health, Seattle, WA, USA
- International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
| | - Alison L. Ensminger
- University of Washington, Department of Global Health, Seattle, WA, USA
- International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
| | | | - Helena Andjamba
- Ministry of Gender Equality and Child Welfare, Government of Namibia, Windhoek, Namibia
| | - Rahimisa Kamuingona
- Ministry of Gender Equality and Child Welfare, Government of Namibia, Windhoek, Namibia
| | - Greta Masseti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachel Coomer
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | - Norbert Forster
- University of Washington, Department of Global Health, Seattle, WA, USA
- International Training and Education Center for Health (I-TECH), University of Washington, Windhoek, Namibia
| | - Gabrielle O’Malley
- University of Washington, Department of Global Health, Seattle, WA, USA
- International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
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Velloza J, Davies L, Ensminger A, Theofelus FM, Andjamba H, Kamuingona R, Nakuta J, Uiras W, Massetti G, Coomer R, Wolkon A, Forster N, O'Malley G. Disclosure and help-seeking behaviors related to sexual and physical violence in childhood and adolescence: Results from the Namibia Violence Against Children and Youth Survey. Child Abuse Negl 2022; 128:105624. [PMID: 35381545 PMCID: PMC9119951 DOI: 10.1016/j.chiabu.2022.105624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND Violence disclosure and help-seeking can mitigate adverse health effects associated with childhood violence, but little is known about facilitators and barriers of disclosure and help-seeking behaviors in sub-Saharan Africa. OBJECTIVE To understand factors associated with disclosure and help-seeking to inform care. PARTICIPANTS AND SETTING Participants aged 13-24 years old in the 2019 Namibia Violence Against Children and Youth Survey (VACS). METHODS We assessed the prevalence of victimization, disclosure, and help-seeking and examined factors associated with violence disclosure and help-seeking, separately, by gender. RESULTS 4211 girls and 980 boys participated in the Namibia VACS. The prevalence of childhood sexual violence differed significantly by gender (15.7% among girls, 9.8% among boys), but physical violence prevalence did not differ by gender. Among victims of sexual violence, 57.3% of girls disclosed and 10.4% sought help, compared with only 30.7% and 3.2% of boys. Among victims of physical violence, 61.1% of girls and 53.4% of boys disclosed, and 16.9% of girls and 17.7% of boys sought help. Older age, social support, and experiencing more types of violence were associated with sexual violence disclosure among boys, but none of these factors were associated with sexual violence disclosure among girls. Lower education, perpetrator type, and witnessing violence were associated with physical violence disclosure among girls, while peer support and perpetrator type were associated with physical violence disclosure among boys. CONCLUSIONS Factors associated with childhood violence differed by gender and violence type in Namibia, highlighting a need for gender-specific violence services to facilitate violence disclosure and help-seeking.
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Affiliation(s)
- Jennifer Velloza
- University of Washington, Department of Global Health, Seattle, WA, USA.
| | - Luke Davies
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
| | - Alison Ensminger
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
| | | | - Helena Andjamba
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Rahimisa Kamuingona
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Joyce Nakuta
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Wilhencia Uiras
- Ministry of Gender Equality, Poverty Eradication and Social Welfare (formerly Ministry of Gender Equality and Child Welfare), Government of Namibia, Windhoek, Namibia
| | - Greta Massetti
- Centers of Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA, United States of America
| | - Rachel Coomer
- Centers for Disease Control and Prevention, Division of Global HIV & Tuberculosis, Windhoek, Namibia
| | - Adam Wolkon
- Centers for Disease Control and Prevention, Division of Global HIV & Tuberculosis, Windhoek, Namibia
| | - Norbert Forster
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Windhoek, Namibia
| | - Gabrielle O'Malley
- University of Washington, Department of Global Health, Seattle, WA, USA; International Training and Education Center for Health (I-TECH), University of Washington, Seattle, WA, USA
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Agathis NT, Annor FB, Coomer R, Hegle J, Patel P, Forster N, O'Malley G, Ensminger AL, Kamuingona R, Andjamba H, Manyando M, Massetti GM. HIV Prevention Program Eligibility Among Adolescent Girls and Young Women - Namibia, 2019. MMWR Morb Mortal Wkly Rep 2021; 70:1570-1574. [PMID: 34758009 PMCID: PMC8580202 DOI: 10.15585/mmwr.mm7045a2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) relies on comprehensive and reliable population data to implement interventions to reduce HIV transmission in high-incidence areas among populations disproportionately affected by the HIV epidemic. Adolescent girls and young women in sub-Saharan Africa account for a disproportionate number of new HIV infections compared with their male peers (1). The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) program includes multisectoral, layered interventions aimed at reducing factors that contribute to vulnerability to HIV infection among adolescent girls and young women in PEPFAR-supported sub-Saharan African countries (1). Namibia, a southern African country with a population of approximately 2.55 million among whom approximately 8% live with HIV infection, had their DREAMS program first implemented in 2017* (2,3). Data from the 2019 Namibia Violence Against Children and Youth Survey (VACS), the most recent and comprehensive nationally representative data source available to study the epidemiology of violence and other HIV risk factors, were used to estimate the percentage of adolescent girls and young women aged 13-24 years who would be eligible for DREAMS program services. The prevalence of individual DREAMS eligibility criteria, which comprise known age-specific risk factors associated with HIV acquisition, were estimated by age group. Among all adolescent girls and young women in Namibia, 62% were eligible for DREAMS based on meeting at least one criterion. Common eligibility criteria included adverse childhood experiences, specifically exposure to physical, emotional, and sexual violence and being an orphan;† and high-risk behaviors, such as early alcohol use,§ recent heavy alcohol use,¶ and infrequent condom use.** Using VACS data to estimate the prevalence of HIV risk factors and identify adolescent girls and young women at elevated risk for HIV acquisition in countries like Namibia with high HIV-incidence can inform programs and policies aimed at improving the well-being of these adolescent girls and young women and help control the HIV epidemics in these countries.
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Coomer R. Getting the rabbit out of the hat. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Coomer
- Cotts Equine Hospital Pembrokeshire Wales UK
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Coomer R. Can ocular administration of atropine cause colic? EQUINE VET EDUC 2020. [DOI: 10.1111/eve.12881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Coomer
- Cotts Equine Hospital Narberth Pembrokeshire UK
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Affiliation(s)
- R. Coomer
- Cotts Equine Hospital; Robeston Wathen; Narberth Pembrokeshire
| | - S. McKane
- Cotts Equine Hospital; Robeston Wathen; Narberth Pembrokeshire
| | - V. Roberts
- School of Veterinary Sciences; University of Bristol; Langford North Somerset UK
| | - D. Gorvy
- Mälaren Equine Clinic; Sigtuna Sweden
| | - T. Mair
- Bell Equine Veterinary Clinic; Maidstone Kent UK
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Affiliation(s)
- R. Coomer
- Cotts Equine Hospital; Pembrokeshire; UK
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Brogniez L, Desbrosse F, Kirschvink N, Vandeweerd JMEF, Launois TM, Perrin RAR, Horn L, Clegg PD, Coomer R, Gabriel A, Mesnil S, Carstanjen B. Treatment of a severe distal forelimb wound presenting with extensive laceration and distal interphalangeal joint luxation in a donkey. PFERDEHEILKUNDE 2012. [DOI: 10.21836/pem20120204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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