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1.
ObjectiveTo investigate the joint effect of child abuse and neglect (CAN) and community violence (CV) on adolescents with peers that commit youth violence (YV).MethodsThis is a school-based cross-sectional study of 699 students enrolled in four public and nine private schools in the municipality of Rio de Janeiro, Brazil. Participants were selected through a complex cluster sampling procedure. CAN was identified using the Childhood Trauma Questionnaire (CTQ). Exposure to CV was assessed by asking students if they have witnessed cases of lethal violence in the community. YV was measured indirectly through questions about having friends who have committed acts of crime. Multivariate logistic models were used to study the effects of emotional, physical, and sexual abuse and emotional and physical neglect in childhood on YV, controlled for confounders, according to different levels of CV.ResultsEmotional abuse OR = 3.32 (CI 95%: 1.79–6.17), sexual abuse OR = 2.33 (CI 95%: 1.20–4.54), and physical neglect OR = 1.81 (CI 95%: 1.02–3.20) increased the odds of YV in adolescents, whether cooccurring with CV or not. Physical abuse OR = 3.95 (CI 95%: 2.29 - 6.80) and emotional neglect OR = 2.93 (CI 95%: 1.83–4.72) are only risk factors for YV involvement when associated with CV.ConclusionsThese findings highlight the relevance of CAN and CV as risk factors for YV and the potential increase in adolescents’ vulnerability when exposed to both. Policies aiming at preventing and dealing with CAN are essential strategies to reduce YV, especially in areas with high levels of CV.  相似文献   

2.
IntroductionCoerced and forced sexual initiation (FSI) can have detrimental effects on children and youth. Understanding health outcomes that are associated with experiences of FSI is important for developing appropriate strategies for prevention and treatment of FSI and its consequences.MethodsThe Violence Against Children Surveys were conducted in Nigeria, Uganda, and Zambia in 2014 and 2015. We examined the prevalence of FSI and its consequences (sexual high-risk behaviors, violence experiences, mental health outcomes, and sexually transmitted infections (STI)) associated with FSI among youth aged 13–24 years in three countries in sub-Saharan Africa.ResultsOver one in ten youth aged 13–24 years who had ever had sex experienced FSI in Nigeria, Uganda, and Zambia. In multivariable logistic regression, FSI was significantly associated with infrequent condom use (OR = 1.4, 95%CI = 1.1–2.1), recent experiences of sexual violence (OR = 1.6, 95%CI: 1.1–2.3), physical violence (OR = 2.2, 95%CI: 1.6–3.0), and emotional violence (OR = 2.0, 95%CI: 1.3–2.9), moderate/serious mental distress (OR = 1.5, 95%CI: 1.1–2.0), hurting oneself (OR = 2.0, 95%CI: 1.3–3.1), and thoughts of suicide (OR = 1.5, 95%CI: 1.1–2.3), after controlling for demographic characteristics. FSI was not statistically associated with engaging in transactional sex, having multiple sex partners, or having a STI.ConclusionFSI is associated with infrequent condom use, recent experiences of violence and mental health outcomes among youth in sub-Saharan Africa, which may increase the risk for HIV and other consequences. Developing strategies for prevention is important for reducing the prevalence of FSI and its effects on children and youth.  相似文献   

3.
Repeated exposure to childhood adversity (abuse, neglect and other traumas experienced before age 18) can have lifelong impacts on health. For HIV-infected adolescents and youth, such impacts may include onward transmission of HIV. To evaluate this possibility, the current study measured the burden of childhood adversity and its influence on risky health behaviors among perinatally-infected adolescents and youth. We surveyed 250 perinatally-infected adolescents and youth (13–24 years) receiving care in Soweto, South Africa. Both male and female participants reported on childhood adversity (using the ACE-IQ), sexual behavior, and psychosocial state. Viral load was also abstracted from their charts. We used logistic regressions to test the association between cumulative adversity and behavioral outcomes. Half the sample reported eight or more adversities. Overall, 72% experienced emotional abuse, 59% experienced physical abuse, 34% experienced sexual abuse, 82% witnessed domestic violence, and 91% saw someone being attacked in their community. A clear gradient emerged between cumulative adversities and behavioral risk. Having experienced one additional childhood adversity raised the odds of risky sexual behavior by almost 30% (OR 1.27, 95% CI 1.09–1.48). Viral suppression was poor overall (31% had viral loads >400 copies/ml), but was not related to adversity. Adversity showed a robust relationship to depression and substance abuse. Childhood adversity is common, influences the current health of HIV-positive adolescents and youth, and puts their sexual partners at risk for HIV infection. Greater primary prevention of childhood adversity and increased access to support services (e.g., mental health) could reduce risk taking among HIV-positive adolescents and youth.  相似文献   

4.
OBJECTIVE: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. METHOD: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. RESULTS: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. CONCLUSION: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem.  相似文献   

5.
To determine whether different types of childhood adversity are associated with body mass index (BMI) in adolescence, we studied 147 adolescents aged 13–17 years, 41% of whom reported exposure to at least one adversity (maltreatment, abuse, peer victimization, or witness to community or domestic violence). We examined associations between adversity type and age- and sex-specific BMI z-scores using linear regression and overweight and obese status using logistic regression. We adjusted for potential socio-demographic, behavioral, and psychological confounders and tested for effect modification by gender. Adolescents with a history of sexual abuse, emotional abuse, or peer victimization did not have significantly different BMI z-scores than those without exposure (p > 0.05 for all comparisons). BMI z-scores were higher in adolescents who had experienced physical abuse (β = 0.50, 95% CI 0.12–0.91) or witnessed domestic violence (β = 0.85, 95% CI 0.30–1.40). Participants who witnessed domestic violence had almost 6 times the odds of being overweight or obese (95% CI: 1.09–30.7), even after adjustment for potential confounders. No gender-by-adversity interactions were found. Exposure to violence in childhood is associated with higher adolescent BMI. This finding highlights the importance of screening for violence in pediatric practice and providing obesity prevention counseling for youth.  相似文献   

6.
Child maltreatment has been associated with sexual risk behaviors. Previous investigators have typically studied only one form of maltreatment, preventing them from exploring interrelations between forms of maltreatment and their impact on sexual risk behaviors. Thus, this study aims to examine the unique, cumulative, and interactive effects of four maltreatment forms (sexual abuse, physical abuse, neglect, and witnessing interparental violence) on sexual risk behaviors. The sample comprised 1940 sexually active adolescents (Mage = 15.6; 60.8% girls) attending Quebec (Canada) high schools. Regression results showed that all maltreatment forms were associated with having a higher number of sexual partners, casual sexual behavior, and a younger age at first consensual intercourse. Physical abuse and witnessing interparental violence were associated with inconsistent condom use, and physical abuse was associated with sexually transmitted infections. After controlling for all forms of maltreatment (unique effects), analyses showed that sexual abuse, physical abuse, neglect or witnessing interparental violence remained statistically associated depending on the sexual risk behavior. A greater number of forms of maltreatment was associated with more sexual risk behaviors (cumulative effect). When sexual abuse was not experienced, neglect was associated with a higher number of sexual partners (interactive effects). In general, associations between maltreatment and sexual risk behaviors were similar for both genders. The magnitude of the relationship between a specific form of child maltreatment and sexual risk behaviors may be inaccurately estimated when not controlling for other forms of maltreatment.  相似文献   

7.
BackgroundChild maltreatment is a global public health issue that encompasses physical abuse, sexual abuse, emotional abuse, neglect, and exposure to intimate partner violence (IPV). This systematic review and meta-analysis summarises the association between these five forms of child maltreatment and depressive and anxiety disorders.MethodsPublished cohort and case-control studies were included if they reported associations between any form of child maltreatment (and/or a combination of), and depressive and anxiety disorders. A total of 604 studies were assessed for eligibility, 106 met inclusion criteria, and 96 were included in meta-analyses. The data were pooled in random effects meta-analyses, giving odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for each form of child maltreatment.ResultsAll forms of child maltreatment were associated with depressive disorders (any child maltreatment [OR = 2.48, 2.14–2.87]; sexual abuse [OR = 2.11, 1.83–2.44]; physical abuse [OR = 1.78, 1.57–2.01]; emotional abuse [OR = 2.35, 1.74–3.18]; neglect [OR = 1.65, 1.35–2.02]; and exposure to IPV [OR = 1.68, 1.34–2.10]). Several forms of child maltreatment were significantly associated with anxiety disorders (‘any child maltreatment’ [OR = 1.68, 1.33–2.4]; sexual abuse [OR = 1.90, 1.6–2.25]; physical abuse [OR = 1.56, 1.39–1.76]; and neglect [OR = 1.34, 1.09–1.65]). Significant associations were also found between several forms of child maltreatment and post-traumatic stress disorder (PTSD).ConclusionsThere is a robust association between five forms of child maltreatment and the development of mental disorders. The Global Burden of Disease Study (GBD) includes only sexual abuse as a risk factor for depressive and anxiety disorders. These findings support the inclusion of additional forms of child maltreatment as risk factors in GBD.  相似文献   

8.
BackgroundChildhood sexual abuse (CSA) is a serious public health problem worldwide.ObjectivesWe reported the prevalence of CSA and examined its association with risky sexual behaviors and adverse reproductive health outcomes among college students in China.Participants and settingParticipants were 17,966 college students from 130 colleges in Eastern, Central, and Western China, who completed the online questionnaire in January–August 2015.MethodsData were obtained from a cluster-random Internet-based survey. Multivariate logistic regression analyses were employed: risky sexual behaviors and adverse reproductive health outcomes were outcome variables, and various types of CSA were predictor variables, while adjusting for socio-demographic and lifestyle characteristics.ResultsThe overall prevalence of any type of CSA was 27.5%. Most perpetrators were friends/acquaintances (34.6%) or intimate partners (24.7%) of the victims. Respondents who reported penetrative CSA were strongly associated with regular unprotected sex (odds ratio (OR): 3.0, 95% confidence interval (CI): 2.2–4.0), early sexual debut (OR: 5.5, 95% CI: 3.3–9.1), having genital tract symptoms in the last 12 months (OR: 5.0, 95% CI: 4.1–6.0), unintended pregnancy (OR: 6.2, 95% CI: 4.2–9.0), and induced abortion (OR: 5.5, 95% CI: 3.7–8.2) (for boys, the survey asked about history of unintended pregnancy and induced abortion of their sexual partners). A dose-response relationship was found across non-contact, contact, and penetrative CSA.ConclusionsCSA experience may increase the likelihood of risky sexual behaviors and adverse reproductive health outcomes in victims’ early adulthood.  相似文献   

9.
Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities.  相似文献   

10.
BackgroundThere have been estimates that over 150,000 Haitian children are living in servitude. Child domestic servants who perform unpaid labor are referred to as “restavèks.” Restavèks are often stigmatized, prohibited from attending school, and isolated from family placing them at higher risk for experiencing violence. In the absence of national data on the experiences of restavèks in Haiti, the study objective was to describe the sociodemographic characteristics of restavèks in Haiti and to assess their experiences of violence in childhood.MethodsThe Violence Against Children Survey was a nationally representative, cross-sectional household survey of 13–24 year olds (n = 2916) conducted May–June 2012 in Haiti. A stratified three-stage cluster design was used to sample households and camps containing persons displaced by the 2010 earthquake. Respondents were interviewed to assess lifetime prevalence of physical, emotional, and sexual violence occurring before age 18. Chi-squared tests were used to assess the association between having been a restavèk and experiencing violence in childhood.FindingsIn this study 17.4% of females and 12.2% of males reported having been restavèks before age 18. Restavèks were more likely to have worked in childhood, have never attended school, and to have come from a household that did not have enough money for food in childhood. Females who had been restavèks in childhood had higher odds of reporting childhood physical (OR 2.04 [1.40–2.97]); emotional (OR 2.41 [1.80–3.23]); and sexual violence (OR 1.86 [95% CI 1.34–2.58]) compared to females who had never been restavèks. Similarly, males who had ever been restavèks in childhood had significantly increased odds of emotional violence (OR 3.06 [1.99–4.70]) and sexual violence (OR 1.85 [1.12–3.07]) compared to males who had never been restavèks, but there was no difference in childhood physical violence.InterpretationThis study demonstrates that child domestic servants in Haiti experience higher rates of childhood violence and have less access to education and financial resources than other Haitian children. These findings highlight the importance of addressing both the lack of human rights law enforcement and the poor economic circumstances that allow the practice of restavèk to continue in Haiti.  相似文献   

11.
ObjectiveAlthough child maltreatment is associated with later non-suicidal self-injury (NSSI), the mechanism through which it might lead to NSSI is not well understood. The current retrospective case–control study examined associations between child maltreatment and later NSSI, and investigated the mediating roles of dissociation, alexithymia, and self-blame.MethodsParticipants were 11,423 Australian adults (response rate 38.5%), randomly selected from the Australian Electronic White Pages, aged between 18 and 100 (M = 52.11, SD = 16.89), 62.2% female. Data were collected via telephone interviewing. Main outcome measures were reported history of child maltreatment (sexual abuse, physical abuse, neglect) and reported 12-month NSSI. Dissociation, alexithymia, and self-blame were examined as potential mediating variables in the relationship between child maltreatment and later NSSI. All analyses were conducted using logistic regression and adjusted for age and psychiatric diagnosis.ResultsResults differed by gender. Compared to no child maltreatment, physical abuse (OR 2.75, 95% CI 1.68–4.51) and neglect (OR 2.56, 95% CI 1.65–3.99) independently increased the odds of NSSI among females. Physical abuse (OR 2.69, 95% CI 1.44–5.03) increased the odds of NSSI among males. Sexual abuse did not independently increase the odds of NSSI for males or females. For females, self-blame had the greatest effect on the child maltreatment–NSSI relationship (OR decreased by 14.6%, p < .000), although dissociation and alexithymia also partially mediated the relationship. For males, dissociation had the greatest effect (OR decreased by 12.9%, p = .003) with self-blame also having a relatively strong effect.ConclusionsThe results indicate that child maltreatment, and in particular, physical abuse, is strongly associated with the development of subsequent NSSI and may be partially mediated by dissociation, alexithymia, and self-blame for females and dissociation and self-blame for males. Altering attributional style (through cognitive therapy or emotion focussed therapy) and improving the capacity to regulate emotions (through dialectical behaviour therapy) may contribute to reduction or cessation of NSSI.  相似文献   

12.
BackgroundChildhood maltreatment is associated with eating disorders, but types of childhood maltreatment often co-occur.ObjectiveTo examine associations between childhood maltreatment patterns and eating disorder symptoms in young adulthood.Participants and SettingData came from the National Longitudinal Study of Adolescent to Adult Health (N = 14,322).MethodsLatent class analysis was conducted, using childhood physical neglect, physical abuse, and sexual abuse as model indicators. Logistic regression models adjusted for demographic covariates were conducted to examine associations between childhood maltreatment latent classes and eating disorder symptoms.ResultsIn this nationally representative sample of U.S. young adults (mean age = 21.82 years), 7.3% of participants reported binge eating-related concerns, 3.8% reported compensatory behaviors, and 8.6% reported fasting/skipping meals. Five childhood maltreatment latent classes emerged: “no/low maltreatment” (78.5% of the sample), “physical abuse only” (11.0% of the sample), “multi-type maltreatment” (7.8% of the sample), “physical neglect only” (2.1% of the sample), and “sexual abuse only” (0.6% of the sample). Compared to participants assigned to the “no/low maltreatment” class, participants assigned to the “multi-type maltreatment” class were more likely to report binge eating-related concerns (odds ratio = 1.97; 95% confidence interval [CI]: 1.52, 2.56) and fasting/skipping meals (OR = 1.85; 95% CI: 1.46, 2.34), and participants assigned to the “physical abuse only” class were more likely to report fasting/skipping meals (OR = 1.35; 95% CI: 1.04, 1.76).ConclusionsThis study provides evidence that distinct childhood maltreatment profiles are differentially associated with eating disorder symptoms. Individuals exposed to multi-type childhood maltreatment may be at particularly high risk for eating disorders.  相似文献   

13.
This paper describes the extent to which abused and neglected children report intimate partner violence (IPV) victimization and perpetration when followed up into middle adulthood. Using data from a prospective cohort design study, children (ages 0–11) with documented histories of physical and sexual abuse and/or neglect (n = 497) were matched with children without such histories (n = 395) and assessed in adulthood (Mage = 39.5). Prevalence, number, and variety of four types of IPV (psychological abuse, physical violence, sexual violence, and injury) were measured. Over 80% of both groups – childhood abuse and neglect (CAN) and controls – reported some form of IPV victimization during the past year (most commonly psychological abuse) and about 75% of both groups reported perpetration of IPV toward their partner. Controlling for age, sex, and race, overall CAN [adjusted odds ratio (AOR) = 1.60, 95% CI [1.03, 2.49]], physical abuse (AOR = 2.52, 95% CI [1.17, 5.40]), and neglect (AOR = 1.64, 95% CI [1.04, 2.59]) predicted increased risk for being victimized by a partner via physical injury. CAN and neglect also predicted being victimized by a greater number and variety of IPV acts. CAN and control groups did not differ in reports of perpetration of IPV, although neglect predicted greater likelihood of perpetrating physical injury to a partner, compared to controls. Abused/neglected females were more likely to report being injured by their partner, whereas maltreated males did not. This study found that child maltreatment increases risk for the most serious form of IPV involving physical injury. Increased attention should be paid to IPV (victimization and perpetration) in individuals with histories of neglect.  相似文献   

14.
BackgroundSexual dating violence is highly prevalent within the context of intimate relationships but this form of violence remains understudied among teenagers and emerging adults.ObjectivesTo identify the specific needs of adolescents and emerging adults who reported sexual dating violence, this study aimed to document the: 1) prevalence of sexual DV; 2) perceived social support and help-seeking strategies; 3) facilitating factors and barriers.Participants and settingA total 396 heterosexual youths and emerging adults (aged 14–25) participated in this study focussing on issues associated with romantic and sexual relationships, including experiences of victimization and help-seeking strategies.MethodsThis analysis relied on a mixed methods design. Sexual dating violence in the last 12 months was assessed using an adapted version of the Sexual Experiences Survey (Koss et al., 2007). Semi-structured interviews were conducted with a subsample of 100 youths and emerging adults.ResultsClose to 30% of participants reported having experienced at least one episode of sexual dating violence in the past year. Participants could count on a friend and/or a parent but girls were more likely to seek help compared to boys. Effect sizes were moderate to small. Several barriers were identified, including, having to disclose intimate aspects of their personal life to a stranger.ConclusionGiven ambiguities regarding sexual consent and sexual violence within the context of an intimate relationship, victims expressed reluctance to get formal support. These findings support the relevance of exploring barriers and facilitators to help-seeking to improve access to services for adolescents and emerging adults who report sexual DV.  相似文献   

15.
OBJECTIVE: To examine (1) the prevalence, types, and severity of child abuse and neglect (CAN) and (2) the relationship between CAN and lifetime psychiatric disorders among American Indian women using primary care services. METHODS: A cross-sectional study was conducted among 234 American Indian women, age 18-45 who presented for outpatient ambulatory services at a community-based Indian Health Service Hospital in Albuquerque, New Mexico. Dependent measures included mood, substance abuse, and anxiety disorders as well as posttraumatic stress disorder (PTSD) as measured by the Composite International Diagnostic Interview. CAN was assessed using the Childhood Trauma Questionnaire. RESULTS: Approximately three-quarters of respondents (76.5%; 95% CI = 70.4, 81.7) reported some type of childhood abuse or neglect; over 40% reported exposure to severe maltreatment. Severity of child maltreatment was associated in a dose response manner with lifetime diagnosis of mental disorders. After adjusting for social and demographic correlates, severe child maltreatment was strongly associated with lifetime PTSD (prevalence ratio [PR] 3.9; 95% CI = 1.9, 8.0); and was moderately associated with lifetime substance use disorders (PR = 2.3; 95% CI = 1.6, 3.3); mood disorders (PR = 2.1; 95% CI 1.4, 3.2); and with two or more disorders (PR = 2.3; 95% CI = 1.6, 3.4). CONCLUSION: CAN was common in our sample of American Indian women in primary care and was positively associated with lifetime psychiatric disorders outcomes. Screening for CAN and psychiatric disorders would enhance the treatment of patients seeking primary care services. Primary prevention of child maltreatment might reduce the high prevalence of mental disorders among American Indian women.  相似文献   

16.
17.
Early studies examining parenting in the setting of intimate partner violence (IPV) often focus on abuse by the IPV perpetrator or effects of long term exposure. This review addresses how intimate partner violence impacts victim parenting. Seven databases were searched for the time period 1970–2015. Included were comparative studies involving children 11 years or younger. Quality ranking was based on: confirmation of victim status, consideration of co-perpetration, heterogeneity of the population, and standardization of measurements. Of 13,038 studies reviewed, 33 included studies showed that victimization is associated with negative parenting practices. Based on data presented within individual studies, 21 studies were eligible for meta-analysis which demonstrated modest effect sizes with high levels of heterogeneity. There was a negative correlation between IPV and positive parenting (r = -0.08; 95% CI: −.12, − .04); positive correlation between IPV and physical aggression (r = .17; 95% CI: .11, .23) and neglect (r = .12; 95% CI: .01, .23); and a trend toward positive correlation between IPV and psychological aggression (r = .23; 95% CI: −.94, .47). A synthesis of studies unsuitable for meta-analysis reinforced these findings. The review demonstrated ongoing methodological issues with extant literature.  相似文献   

18.
Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.  相似文献   

19.
This study seeks to assess the impact of economic factors on sexual, emotional, and physical violence on Nigerian children and adolescents aged 13–24 years. Data collected from the Nigerian Violence Against Children Survey (VACS), a national, cross-sectional household survey of females and males aged 13–24 years were used to examine sexual, emotional, and physical violence victimization. Data were collected on household economic status, e.g., flooring and roofing materials, transportation. A poverty index was developed using the Simple Poverty Scorecard for Nigeria to determine the impact that economic factors have on these violence measures. Children aged 13–17 years in households with high economic status (ES) were 1.81, 1.78, and 4.91 times, more likely to experience sexual, emotional, and physical violence, respectively, within the last 12 months than those in the lowest ES. Individuals aged 18–24 years in households with high ES were 1.62 and 1.41 times more likely to experience emotional and physical violence, respectively, prior to age 18 than those in the lowest ES. Individuals aged 18–24 years in households with middle or high ES were 1.65 and 1.96, respectively, times more likely to experience physical violence prior to age 18 than those in the lowest ES. Highest tertile ES was significantly associated with sexual, emotional, and physical violence among Nigerians aged 13–24 years. Further research is needed to determine the cause of increased violence amongst high ES households. Targeted interventions towards this ES class are recommended to reduce violence against children in Nigeria.  相似文献   

20.
Little is known about adolescent exposure to and factors associated with violence in Malawi. The aim of this research was to describe the prevalence of exposure to violence among adolescents in Malawi, and test the hypotheses that such exposures are associated with gender-based violent attitudes, and with internalizing and externalizing problems. In 2014, 561 primary school pupils were interviewed (50% girls), and logistic regression analysis was performed on gender-stratified data, adjusting for sociodemographic differences. Both girls and boys had witnessed domestic violence (28.5% & 29.6%), experienced emotional abuse at home (23.1% & 22.9%), physical abuse at home (28.1% & 30.4%), physical abuse at school (42.4% & 36.4%), and been bullied (33.8% & 39.6%). Among girls, internalized violent attitudes towards women were associated with emotional abuse at home (OR 2.1) and physical abuse at school (OR 1.7). Condoning rape was associated with physical abuse at school (OR 1.9). Bullying perpetration was associated with emotional abuse at home (OR 4.5). Depression was associated with emotional abuse at home (OR 3.8) and physical abuse at school (OR 2.4). Among boys, violent attitudes towards women and condoning rape were not associated with violence exposure. Bullying perpetration was associated with having been a victim of bullying (OR 2.9) and physical abuse at school (OR 2.7). Depression was associated with emotional abuse at home (OR 2.9), domestic violence (OR 2.4) and physical abuse at school (OR 2.5). These findings can inform programs designed to reduce violence victimization among Malawian girls, both in homes and schools.  相似文献   

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