Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention

BMC Public Health

Research Article

Zishan Cui¹  Jason Chia¹  Nathan J. Lachowsky²  Addy Musuku³  Cari L. Miller³  Angela Kaida³  Kalysha Closson⁴  Robert S. Hogg⁴  Glenda Gray⁵  Janan Janine Dietrich⁵  Busi Nkala⁶ 

[1] British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada;British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada;School of Public Health and Social Policy, University of Victoria, Victoria, Canada;Faculty of Health Sciences, Simon Fraser University (SFU), Blusson Hall Rm 10522, 8888 University Drive, BC V5A 1S6, Burnaby, Canada;Faculty of Health Sciences, Simon Fraser University (SFU), Blusson Hall Rm 10522, 8888 University Drive, BC V5A 1S6, Burnaby, Canada;British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada;Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa;

关键词: Adolescent;    Young adult;    Youth;    HIV;    Prevention;    Trauma;    Potentially traumatic events;    Sexual and reproductive health;    South Africa;   

DOI  :  10.1186/s12889-016-3832-0

 received in 2016-05-21, accepted in 2016-11-12,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundYouth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa.MethodsUsing data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of “ever” experiencing a traumatic event among adolescents (aged 14–19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of ‘high PTE score’ (≥7 PTEs).ResultsOverall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., “seen an act of violence in the community”) whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., “family member or someone close died of HIV/AIDS”). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37).ConclusionNearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services.

【 授权许可】

CC BY   
© The Author(s). 2016