Abstract
BackgroundSexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.MethodsA cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or sexual abuse before 15 years of age, forced first sex before 16, HIV risk factors such as age difference at first sex before age 16. Multivariate analyses assessed the associations between mother’s HIV status and child physical and sexual abuse while controlling for confounding variables.ResultsMore than one in four (26.6%) reported abuse before the age of 15: 14.6% physical abuse and 9.1% sexual abuse,14.3% reported forced first sex and 9.0% first sex before 16 with someone 5+ years older. Fifteen percent of women tested HIV positive during the recent antenatal care visit. In multivariate analysis, childhood physical abuse (aOR 3.30 95%CI 1.58–6.90), sexual abuse (3.18 95%CI: 1.64–6.19), forced first sex (aOR 1.42, 95%CI: 1.00–2.02), and 5+ years age difference with first sex partner (aOR 1.66 95%CI 1.09–2.53) were independently associated with HIV infection.ConclusionThis study highlights that child physical and/or sexual abuse may increase risk for HIV acquisition. Further research is needed to assess the pathways to HIV acquisition from childhood to adulthood. Prevention of child abuse must form part of the HIV prevention agenda in Sub-Saharan Africa.
Highlights
Child abuse is a violation of the fundamental rights of children
Participants were interviewed about childhood abuse including physical or sexual abuse before years of age, forced first sex before 16, HIV risk factors such as age difference at first sex before age
This study provides an opportunity to assess if child physical/sexual abuse is associated with HIV diagnosed in pregnancy
Summary
Child abuse is a violation of the fundamental rights of children. research on child abuse is growing globally, research on childhood exposure to violence is a neglected area in many parts of Africa. An extensive review of studies in Africa reported among the highest prevalence of child abuse globally [2]. The prevalence of physical or sexual violence against girls in Africa ranges between 2% and 64% [2] and the wide range is a result of the various definitions of violence adopted and settings where the study was conducted (see http://www.knowviolenceinchildhood.org/). Shumba argues that the use of violence against children in Zimbabwean schools is an extension of violent ways of disciplining a child that teachers transfer from their roles as parents and adults in the community to the school [6]. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women
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