Abstract
Background: South African adolescents experience disproportionally high rates of violence, with lifelong health, social and economic impacts. Few papers present risk factors associated with experiences of adolescent violence. Methods: A baseline cross-sectional survey was done (April 2017 – Sept 2018) with 3432 grade 8 learners in the Girls Achieve Power (GAP Year) trial from 26 high schools in three townships (Soweto and Tembisa, Gauteng and Khayelitsha, Western Cape). Collected data on lifetime experiences of different types of violence, perpetrators, and place of violence. Descriptive statistics and logistic regression were used to enumerate experiences of, and factors associated with violence. Results: A total of 2383 respondents are included. Most (63.1%) were girls, 81.5% aged 12-14. In total 26% had ever experienced violence, higher among boys (p=<0.001). Physical violence was most common (35.7%), then psychological (21.8%), sexual (13.1%), neglect (10.6%), cyberbullying (7.6%), corporal punishment (6.5%) and economic abuse (4.8%). Boys experienced more physical violence (36.0%); girls experienced more psychological violence (22.2%). Gauteng had double the reports of sexual violence (18.4% vs 7.6%, p<0.001). Violence happened most at school (27.4%), followed by the park (19.8%) or their friends’ home (12.9%). Multivariate analysis showed that boys (aOR 1.57; 95% CV 1.27-1.94; p=0.000), those aged 15-17 years (aOR 1.41; 95% CV 1.07-1.84; p=0.013), those who ever used substances (aOR 1.92; 95% CI 1.54-2.37; p=0.000), and those who sometimes feel worthless (aOR 1.35; 95% CI 1.10-1.64, p=0.003) were at higher odds of ever experiencing violence. Those who had never had sex were less likely to have ever experienced violence (aOR 0.66; 95% CI 0.51-0.83; p=0.001). Conclusion: Urgently need wider adoption, scaling, and sustaining of evidence-based primary violence prevention and structural interventions are required to reduce the high burden of adolescent violence. Stakeholders across the ecological model are needed to tackle harmful cultural norms that perpetuate violence.
Highlights
Violence is the ‘intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or neglect’[1]
The bivariate risk and factors associated with violence were estimated using crude odds ratios, at 95% confidence interval (CI) and significance reported at alpha less than 5%
Overall, 3432 eligible learners across 26 schools participated in the baseline survey: we included 2383 in the analysis as this was the number who completed both components of the survey
Summary
Violence is the ‘intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or neglect’[1]. 50% of children aged 2–17 years have experienced physical, sexual or emotional violence in the past year[2]. In South Africa (SA), those under 18 years old experience disproportionally high rates of violence. In the South African ‘Birth to twenty cohort’, 99% had ever been exposed to (seeing or hearing violence) or experienced violence (direct experience) in their home, school or community before they turned 203. In another study by Burton and Leoschut5, 22% of learners aged between 12 –18 years across SA had experienced some form of violence while at school in the past year. South African adolescents experience disproportionally high rates of violence, with lifelong health, social and economic impacts. Physical violence was most common (35.7%), psychological (21.8%), sexual (13.1%), neglect (10.6%), cyberbullying (7.6%), corporal punishment (6.5%) and economic abuse (4.8%). Multivariate analysis showed that boys (aOR 1.57; 95% CV 1.27-1.94; p=0.000), those aged 15-17 years (aOR 1.41; 95% CV 1.07-1.84; p=0.013), those who ever used substances (aOR 1.92; 95% CI 1.542.37; p=0.000), and those who sometimes feel worthless
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