Adverse Childhood Experiences and HIV Risk Behaviors in Young Adult Afghan Immigrants to Eastern Iran

Abstract

This study aims to examine the association between separate and accumulative ACEs and migration-associated HIV risk behaviors among Afghan immigrants to Iran. A retrospective survey was conducted in three provinces of Iran. Respondent-driven sampling (RDS) technique recruited a sample of 772 young adult Afghan immigrants aged 18 to 37 years. Data were collected through structured interviews between January and March 2019. ACEs and HIV risk behaviors were measured, respectively, by an adapted version of the WHO Adverse Childhood Experiences InternationalQuestionnaire (ACE-IQ) and HIV Risk-taking Behavior Scale (HRBS). A notable proportion of participants with a mean percentage of 78.3 ± 10.49 reported cumulative ACEs. Only a mean percentage of 5.5 ± 3.18 of participants reported HIV risk behaviors. After adjusting for intra-class correlation (ICC), significantly higher odds of drug-related behaviors were found among respondents who were exposed to family dysfunction during childhood (aOR= 2.53, 95% CI 1.32–3.75) and those who experienced cumulative childhood adversities (aOR= 1.96, 95% CI 1.09–2.83). Respondents with no education (aOR= 1.38, 95% CI 0.85–1.92), those who were exposed to childhood family dysfunction (aOR= 2.10, 95% CI 1.39–2.81), and those who experienced cumulative childhood adversities (aOR= 2.31, 95% CI 1.33–3.29) were more likely to report sexual risk behaviors. Prevention of ACEs and support for Afghan immigrants exposed to ACEs to develop resilience are essential to improving the HIV health of young adults in future generations. Cumulative ACEs and, separately, family dysfunction, are overlapping risk factors for HIV risk behaviors in young adult Afghan immigrants