Prevalence of adverse childhood experiences among Vietnamese high school students

Abstract

BackgroundAdverse childhood experiences (ACE) are linked to a range of negative health outcomes. However, the majority of research has been conducted in high-income-countries and little is known about ACE prevalence in low-and-middle-income-countries (LMIC), where the majority of the world's youth reside. ObjectiveAssess ACE prevalence and demographic correlates in two provinces of the Southeast Asian LMIC Vietnam. MethodsPrevalence of ACE were assessed among 644 Vietnamese high-school students, using the WHO Adverse Childhood Experiences-International Questionnaire. ResultsAbout 74% of participants reported experiencing at least one ACE, with 27% reporting experiencing three or more ACE. Prevalence of sexual abuse was above 10% for both males and females. Sex differences were non-significant, suggesting child protective services should give consideration to both males and females. Factor analysis identified two patterns of ACE: Violence and Aggression in Family and Community, and Family Member Dysfunction. Three ACE (sexual abuse, emotional neglect, physical neglect) did not load on either factor. Thus, at least in our sample, sexual abuse was independent of other ACE, which indicates that it can occur in any context, among children in otherwise well-functioning families, an important consideration for child protective services. The lack of significant sex differences in sexual abuse means that Vietnamese boys need equal consideration for protection and support as girls. ConclusionsResults indicate that ACE are a prevalent public health problem in Vietnam. Future research evaluating potential ACE risk factors such as authoritarian parenting may be useful to identify possible targets for prevention programs in Vietnam.